Webster Kate E, Klemm Haydn J, Feller Julian A
School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia.
OrthoSport Victoria, Epworth HealthCare, Melbourne, Australia.
Orthop J Sports Med. 2022 Feb 11;10(2):23259671221074999. doi: 10.1177/23259671221074999. eCollection 2022 Feb.
Return to sport is a goal for most patients who undergo anterior cruciate ligament (ACL) reconstruction. However, at a nonelite level, there are limited sport-specific data regarding rates or factors associated with return to play.
To report rates and determinants of returning to play Australian Rules football after ACL reconstruction in male nonprofessional athletes.
Case-series; Level of evidence, 4.
A total of 354 male nonprofessional Australian Rules football players who had undergone primary ACL reconstruction were asked to complete detailed sports activity questions at 12 months and 2 to 5 years (mean, 3 years) after surgery. Rates of return to play were calculated for both timepoints, along with preoperative patient expectations and postoperative sport performance. The following predictors of return to play were examined: age at surgery; height; weight; frequency of weekly football participation; sport participation level; psychological readiness to return to sport; and knee-related quality of life. Further ACL injuries were also documented. Descriptive statistics were used to summarize return-to-play data and contingency analysis for predictors of return to sport.
The rate of return to any level of play was 35% (95% CI, 30%-41%; n = 284) at the 12-month follow-up and 78% (95% CI, 72%-83%; n = 233) at the 2- to 5-year follow-up. Overall, 64% (95% CI, 57%-70%) of the patients were able to return to their same or higher level of play. Before surgery, 92% of the patients expected to return to their same preinjury level of Australian Rules football participation. At the 2- to 5-year follow-up, 61% who returned to play felt that they could perform as well as they could before their ACL injury. A greater psychological readiness to return to sport preoperatively and higher level of sport participation were significant predictors of a return at 2 to 5 years. Further ACL injuries were sustained by 21% of the cohort (15% graft rupture; 6% contralateral ACL injury).
Most male athletes who participate in Australian Rules football returned to some level of play after ACL reconstruction; however, only 64% returned to preinjury levels. Preoperative expectations were not met, and high reinjury rates are a cause for concern.
恢复运动是大多数接受前交叉韧带（ACL）重建手术患者的目标。然而，在非精英水平上，关于恢复运动的发生率或相关因素的特定运动数据有限。
报告男性非职业运动员ACL重建术后恢复参加澳式橄榄球运动的发生率及决定因素。
病例系列研究；证据等级为4级。
共有354名接受初次ACL重建手术的男性非职业澳式橄榄球运动员被要求在术后12个月以及2至5年（平均3年）时完成详细的体育活动问题调查。计算两个时间点的恢复运动发生率，同时调查术前患者期望和术后运动表现。研究以下恢复运动的预测因素：手术年龄、身高、体重、每周参加橄榄球运动的频率、运动参与水平、恢复运动的心理准备情况以及膝关节相关生活质量。还记录了进一步的ACL损伤情况。使用描述性统计来总结恢复运动数据，并对恢复运动的预测因素进行列联分析。
在12个月随访时，恢复到任何运动水平的发生率为35%（95%CI，30%-41%；n = 284），在2至5年随访时为78%（95%CI，72%-83%；n = 233）。总体而言，64%（95%CI，57%-70%）的患者能够恢复到相同或更高的运动水平。术前，92%的患者期望恢复到受伤前相同的澳式橄榄球参与水平。在2至5年随访时，恢复运动的患者中有61%认为他们的表现与ACL损伤前一样好。术前恢复运动的心理准备更充分以及运动参与水平更高是2至5年恢复运动的显著预测因素。该队列中有21%的患者发生了进一步的ACL损伤（15%为移植物破裂；6%为对侧ACL损伤）。
大多数参加澳式橄榄球运动的男性运动员在ACL重建术后恢复到了一定的运动水平；然而，只有64%恢复到了受伤前的水平。术前期望未得到满足，高再损伤率令人担忧。
