Marigi Erick M, Song Bryant M, Wasserburger Jory N, Camp Christopher L, Levy Bruce A, Stuart Michael J, Okoroha Kelechi R, Krych Aaron J
Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, USA.
Orthop J Sports Med. 2022 May 5;10(5):23259671221092770. doi: 10.1177/23259671221092770. eCollection 2022 May.
Wrestling is a physically demanding sport, with young athletes prone to anterior cruciate ligament (ACL) injuries. There is a paucity of data evaluating the results of ACL reconstruction (ACLR) in this cohort.
To assess return to sport (RTS), patient-reported outcomes, reoperation rates, and graft survival after ACLR in a large cohort of competitive wrestlers at midterm follow-up.
Case series; Level of evidence, 4.
We identified all competitive wrestlers (club, high school, collegiate, or professional) with a history of an ACLR at a single institution between 2000 and 2019. Graft failure was defined as a retear (as determined via clinical or advanced imaging evaluation) and/or revision ACLR. All patients were contacted for determination of reinjury rates; current sport status; and pain visual analog scale, International Knee Documentation Committee, and Tegner activity scores.
Included were 107 knees in 103 wrestlers, with a median follow-up time of 5.9 years (interquartile range [IQR], 3.9-10.3 years). The median age was 17 years (IQR, 15-18 years), with 106 (99%) male patients, and the distribution of bone-patellar tendon-bone (BTB) and hamstring tendon (HT) autografts was 64 (60%) and 43 (40%), respectively. At final follow-up, 80% of athletes were able to RTP at a median of 280 days (IQR, 212-381 days). Graft failure occurred in 14 (13%) knees at a median time of 1.8 years (IQR, 0.7-5.3 years) after the index ACLR. BTB autograft demonstrated a lower failure rate compared with HT autograft (8% vs 21%; = .044) and was associated with better survival compared with HT autograft up to 15 years after the index ACLR (90.4% vs 76.3%; = .030). When compared by graft diameter, HT autografts of at least 7.5 mm were not associated with a lower graft failure than BTB constructs of all sizes ( = .205).
Return to competitive wrestling was observed in 80% of athletes after ACLR, with 14% of wrestlers experiencing graft failure. BTB autograft was associated with better survival than HT autograft.
摔跤是一项对身体要求很高的运动，年轻运动员容易发生前交叉韧带（ACL）损伤。评估该队列中ACL重建（ACLR）结果的数据较少。
在一大群竞技摔跤运动员的中期随访中，评估ACLR后的运动恢复（RTS）、患者报告的结果、再次手术率和移植物存活率。
病例系列；证据等级，4级。
我们确定了2000年至2019年间在单一机构有ACLR病史的所有竞技摔跤运动员（俱乐部、高中、大学或职业）。移植物失败定义为再次撕裂（通过临床或先进影像评估确定）和/或翻修ACLR。联系所有患者以确定再损伤率、当前运动状态以及疼痛视觉模拟量表、国际膝关节文献委员会和Tegner活动评分。
纳入了103名摔跤运动员的107个膝关节，中位随访时间为5.9年（四分位间距[IQR]，3.9 - 10.3年）。中位年龄为17岁（IQR，15 - 18岁），男性患者106名（99%），骨 - 髌腱 - 骨（BTB）和腘绳肌腱（HT）自体移植物的分布分别为64例（60%）和43例（40%）。在最后随访时，80%的运动员能够在中位时间280天（IQR，212 - 381天）恢复运动。14个（13%）膝关节发生移植物失败，中位时间为初次ACLR后1.8年（IQR，0.7 - 5.3年）。BTB自体移植物的失败率低于HT自体移植物（8%对21%；P = 0.044），并且与初次ACLR后长达15年的HT自体移植物相比，其存活率更高（分别为90.4%对76.3%；P = 0.030）。按移植物直径比较时，至少7.5mm的HT自体移植物与所有尺寸的BTB移植物相比，移植物失败率并无降低（P = 0.205）。
ACLR后80%的运动员恢复了竞技摔跤，14%的摔跤运动员经历了移植物失败。BTB自体移植物的存活率高于HT自体移植物。
