Baker Hayden P, Lin Ye, Lee Cody S, Portney Daniel A, Scott Bryan, Athiviraham Aravind
Department of Orthopaedic Surgery, The University of Chicago, Chicago, Illinois, U.S.A.
Arthrosc Sports Med Rehabil. 2022 Jul 15;4(4):e1489-e1495. doi: 10.1016/j.asmr.2022.05.011. eCollection 2022 Aug.
To investigate the effect of multiple concussions on the risk of lower-extremity injuries in National Football League (NFL) players.
All active NFL players from September 2016 to January 2017 through September 2019 to January 2020 regular seasons were eligible for inclusion. All players who sustained multiple concussions during the study period were identified using publicly available data and included in the multiple concussion (MC) cohort. Players who sustained a single concussion (SC) as well as controls were age and position matched to the MC cohort using MEDCALC case-control. Lower-extremity injuries were then documented for the players included in all 3 cohorts.
The odds of sustaining a lower-extremity injury were significantly greater in the MC as well as the SC cohort when compared with the no concussion (NC)-matched cohort (odds ratio 2.92, standard deviation [SD] 1.7-4.9) and 2.28 (SD 1.5-3.6), respectively. However, we found no significant difference in the odds of sustaining a lower-extremity injury when comparing the SC with the MC cohort (odds ratio 1.00, SD 0.7-1.3). The time to lower-extremity injury after return to play from a concussion was significantly shorter in the SC group when compared with the MC group, within 1 year following a concussion injury ( = .01).
There was a significant increase in the odds of suffering a lower-extremity injury after return to play in NFL players exposed to SC or MC when compared with age- and position-matched controls who did not sustain a concussion within the study period. There was no significant difference in the odds of suffering a lower-extremity injury after return to play for NFL players exposed to MC when compared with players exposed to a SC during our study period. Our findings suggest a potential need for injury-prevention protocols following concussion injuries.
Level III, retrospective comparative prognostic trial.
研究多次脑震荡对美国国家橄榄球联盟（NFL）球员下肢受伤风险的影响。
2016年9月至2017年1月以及2019年9月至2020年1月常规赛期间所有现役NFL球员均符合纳入标准。利用公开数据确定在研究期间遭受多次脑震荡的所有球员，并将其纳入多次脑震荡（MC）队列。遭受单次脑震荡（SC）的球员以及对照组通过MEDCALC病例对照法，在年龄和位置上与MC队列进行匹配。随后记录所有3个队列中球员的下肢受伤情况。
与无脑震荡（NC）匹配队列相比，MC队列以及SC队列中发生下肢受伤的几率显著更高，分别为比值比2.92，标准差（SD）1.7 - 4.9）和2.28（SD 1.5 - 3.6）。然而，比较SC队列与MC队列时，我们发现发生下肢受伤的几率没有显著差异（比值比1.00，SD 0.7 - 1.3）。与MC组相比，脑震荡后恢复比赛至下肢受伤的时间在SC组显著更短，在脑震荡损伤后的1年内（P = .01）。
与在研究期间未遭受脑震荡的年龄和位置匹配的对照组相比，遭受SC或MC的NFL球员恢复比赛后下肢受伤的几率显著增加。在我们的研究期间，与遭受SC的球员相比，遭受MC的NFL球员恢复比赛后下肢受伤的几率没有显著差异。我们的研究结果表明脑震荡损伤后可能需要制定预防损伤方案。
III级，回顾性比较预后试验。
