Houston Methodist Orthopedics and Sports Medicine, Houston, USA.
Fortius Clinic, 17 Fitzhardinge Street, London, W1H 6EQ, UK.
Knee Surg Sports Traumatol Arthrosc. 2022 Oct;30(10):3393-3401. doi: 10.1007/s00167-022-06926-3. Epub 2022 Mar 13.
The purpose of the study is to assess return to play rate and timing of elite athletes treated for multi-ligament knee injuries with modern surgical techniques.
A retrospective review was performed of all professional or national/international level athletes treated for a multi-ligament knee injury by the senior author in the period from February 2001 to October 2019, with a minimum of 2-year follow-up. The study cohort consisted of 136 elite athletes who underwent surgery of two or more knee ligaments. Outcomes measures were return to play (RTP), defined as return to elite level sport, return to play time, and further surgical procedures.
One hundred and twenty (88.2%) athletes returned to elite level sport at an average of 12.8 months from operation. In unicruciate injuries, ACL and PCL-based injuries had similar return to play rates (89.1% vs. 87.5% respectfully, n.s.) although mean RTP time was longer in those with PCL-based injuries (15.2 vs. 11.9 months, p < 0.01). Bicruciate injuries had longer RTP times compared to unicruciate injuries (mean RTP 16.0vs. 12.4 months, p < 0.05) but were able to return at a similar rate (83.3% vs. 88.9%, n.s.). Medial and lateral sided injuries had similar RTP rates (89.3% vs. 87.9%, n.s.) though lateral sided injuries took longer before returning to play (13.4 vs. 11.6 months, p < 0.05). Further surgery was required in 54 (39.9%) patients including 25 (18.4%) manipulations under anaesthesia. Four (2.9%) of the athletes underwent revision ligament surgery.
Modern surgical techniques used in the treatment of multi-ligament knee injuries can lead to high return to play rates in elite athletes.
IV.
本研究旨在评估采用现代手术技术治疗多韧带膝关节损伤的精英运动员的重返赛场率和时间。
对 2001 年 2 月至 2019 年 10 月期间由资深作者治疗的多韧带膝关节损伤的所有职业或国家/国际水平的运动员进行回顾性分析，随访时间至少为 2 年。研究队列包括 136 名接受 2 个或更多膝关节韧带手术的精英运动员。主要观察指标是重返赛场（RTP），定义为重返精英运动水平、重返赛场时间和进一步的手术程序。
120 名（88.2%）运动员平均在手术后 12.8 个月返回精英运动水平。在单十字韧带损伤中，ACL 和 PCL 损伤的 RTP 率相似（分别为 89.1%和 87.5%，无统计学差异），但 PCL 损伤的 RTP 时间更长（15.2 个月比 11.9 个月，p<0.01）。双十字韧带损伤的 RTP 时间比单十字韧带损伤长（平均 RTP 16.0 个月比 12.4 个月，p<0.05），但 RTP 率相似（83.3%比 88.9%，无统计学差异）。内侧和外侧损伤的 RTP 率相似（分别为 89.3%和 87.9%，无统计学差异），但外侧损伤的重返赛场时间更长（13.4 个月比 11.6 个月，p<0.05）。54 名（39.9%）患者需要进一步手术，包括 25 名（18.4%）在麻醉下进行的手法复位。4 名（2.9%）运动员接受了韧带重建手术。
多韧带膝关节损伤采用现代手术技术治疗，可使精英运动员的 RTP 率较高。
IV 级。
