Ortiz Ezequiel, Zicaro Juan Pablo, Garcia Mansilla Ignacio, Yacuzzi Carlos, Costa-Paz Matias
Knee Division, Hospital Italiano de Buenos Aires, Ciudad Autónoma 1181, Buenos Aires, Argentina.
World J Orthop. 2022 Sep 18;13(9):812-824. doi: 10.5312/wjo.v13.i9.812.
Between 43% and 75% of patients who undergo primary anterior cruciate ligament (ACL) surgery return to sport activity. However, after a revision ACL reconstruction (ACLR) the rate of return to sports is variable. A few publications have reported returns to sports incidence between 56% to 100% after revision ACLR.
To determine return to sports and functional outcomes after a single-stage revision ACLR with a 5-year minimum follow-up at a single institution.
All patients operated between 2010 and 2016 with a minimum 5 years of follow-up were included. Type of sport, intensity, frequency, expectation, time to return to sport and failure rate were recorded. Lysholm, Tegner and International Knee Documentation Committee forms were evaluated prior to the first ACLR surgery, at 6 mo after primary surgery and after revision ACLR at 5 years minimum of follow-up. Objective stability was tested with the knee arthrometer test (KT-1000 knee arthrometer, Medmetric Corp).
A total of 41 patients who underwent revision ACLR during that period of time were contacted and available for follow-up. Median patient age at time of revision was 29 years old [interquartile range (IQR): 24.0-36.0], and 39 (95.0%) were male. The median time from revision procedure to follow-up was 70 mo (IQR: 58.0-81.0). Regarding return to sports, 16 (39.0%) were at the same level compared to preinjury period, and 25 patients (61.0%) returned at a lower level. Sixty-three percent categorized the sport as very important and 37.0% as important. One patient (2.4%) failed with a recurrent ACL torn. Mean preoperative Lysholm and subjective International Knee Documentation Committee scores were 58.8 [standard deviation (SD) 16] and 50 (SD 11), respectively. At follow-up, mean Lysholm and subjective International Knee Documentation Committee scores were 89 (SD 8) and 82 (SD 9) ( = 0.0001). Mean Tegner score prior to primary ACLR was 6.7 (SD 1.3), 5.1 (1.5 SD) prior to revision ACLR and 5.6 (1.6 SD) at follow-up ( = 0.0002). Overall, knee arthrometer test measurement showed an average of 6 mm (IQR: 4.0-6.0) side-to-side difference of displacement prior to revision ACLR and 3mm (IQR: 1.5-4.0) after revision.
Almost 40.0% of patients returned to preinjury sports level and 60.0% to a lower level. These may be useful when counseling a patient regarding sports expectations after a revision ACLR.
接受初次前交叉韧带（ACL）手术的患者中，43%至75%的人恢复了体育活动。然而，在ACL翻修重建（ACLR）后，恢复运动的比例各不相同。一些出版物报道，ACLR翻修术后恢复运动的发生率在56%至100%之间。
确定在单一机构进行至少5年随访的单阶段ACLR翻修术后的运动恢复情况和功能结果。
纳入2010年至2016年期间接受手术且至少随访5年的所有患者。记录运动类型、强度、频率、期望、恢复运动的时间和失败率。在首次ACLR手术前、初次手术后6个月以及至少随访5年的ACLR翻修术后，对Lysholm、Tegner和国际膝关节文献委员会的表格进行评估。使用膝关节测功仪测试（KT - 1000膝关节测功仪，Medmetric公司）测试客观稳定性。
在那段时间里，共有41例接受ACLR翻修术的患者被联系并可供随访。翻修时患者的中位年龄为29岁[四分位间距（IQR）：24.0 - 36.0]，39例（95.0%）为男性。从翻修手术到随访的中位时间为70个月（IQR：58.0 - 81.0）。关于恢复运动情况，16例（39.0%）恢复到受伤前的相同水平，25例（61.0%）恢复到较低水平。63%的人将运动归类为非常重要，37.0%的人认为重要。1例患者（2.4%）因ACL再次撕裂而失败。术前Lysholm评分和主观国际膝关节文献委员会评分的平均值分别为58.8[标准差（SD）16]和50（SD 11）。随访时，Lysholm评分和主观国际膝关节文献委员会评分的平均值分别为89（SD 8）和82（SD 9）（P = 0.0001）。初次ACLR术前Tegner评分的平均值为6.7（SD 1.3），ACLR翻修术前为5.1（SD 1.5），随访时为5.6（SD 1.6）（P = 0.0002）。总体而言，膝关节测功仪测试测量显示，ACLR翻修术前两侧位移平均差异为6mm（IQR：4.0 - 6.0），翻修术后为3mm（IQR：1.5 - 4.0）。
近40.0%的患者恢复到受伤前的运动水平，60.0%的患者恢复到较低水平。在为患者提供关于ACLR翻修术后运动期望的咨询时，这些数据可能会有所帮助。
