C.E.R.S., Groupe Ramsay Santé, 83 Av Maréchal de Lattre de Tassigny, 40130, Capbreton, France.
Service de Chirurgie Orthopédique Et Traumatologie, Hôpital d'Instruction Des Armées Sainte-Anne, 2, Bd Sainte Anne, BP 600, 83800, Cedex 9, Toulon, France.
Int Orthop. 2024 Feb;48(2):455-463. doi: 10.1007/s00264-023-05973-w. Epub 2023 Sep 13.
Individual factors of low rates of return to sport after anterior cruciate ligament (ACL) reconstruction were unclear. We evaluated the impact of various individual factors after ACL reconstruction for return to sport in athletes.
A prospective study was performed in 1274 athletes, who had undergone ACL autograft reconstruction. Individual factors survey about return to sport was performed during the second year after surgery. Athlete responses were analyzed with a multivariate logistic model adjusted for baseline patient characteristics and an adjusted Cox model.
Younger age and involvement in higher-level sporting activities were associated with a significantly higher frequency and a significantly shorter time to return to sport (running, training, competition; p = 0.001 to 0.028). Men returned to sport more rapidly than women, for both training (p = 0.007) and competition (p = 0.042). Although there was no difference to return to sport between hamstring (HT) and patellar tendon (PT) autograft. We note that MacFL surgery (Mac Intosh modified with intra- and extra-articular autografts used the tensor fasciae latae muscle) was associated with a higher frequency (p = 0.03) and rapidity (p = 0.025) of return to training than HT. Sports people practicing no weight-bearing sports returned to training (p < 0.001) and competition (p < 0.001) more rapidly than other sports people. By contrast, the practicing pivoting sports with contact started running again sooner (p < 0.001).
Younger age, male sex, higher level of sports, sportspeople practicing no weight-bearing sports, and MacFL surgery reduce time to return to sport after ACL reconstruction.
前交叉韧带（ACL）重建后运动恢复率低的个体因素尚不清楚。我们评估了 ACL 重建后运动员重返运动的各种个体因素的影响。
对 1274 名接受 ACL 自体移植物重建的运动员进行了前瞻性研究。术后第二年进行了关于重返运动的个体因素调查。使用多变量逻辑模型对运动员的反应进行分析，并根据基线患者特征和调整后的 Cox 模型进行调整。
年龄较小和参与高水平运动与更高的运动恢复频率和更短的运动恢复时间显著相关（跑步、训练、比赛；p=0.001 至 0.028）。男性比女性更快地恢复运动，无论是训练（p=0.007）还是比赛（p=0.042）。尽管腘绳肌（HT）和髌腱（PT）自体移植物之间的运动恢复没有差异。我们注意到 MacFL 手术（Mac Intosh 改良术，使用阔筋膜张肌和关节内和关节外自体移植物）与更快的训练恢复频率（p=0.03）和速度（p=0.025）相关。不进行负重运动的运动人士比其他运动人士更快地恢复训练（p<0.001）和比赛（p<0.001）。相比之下，从事有接触的旋转运动的运动员更早地开始跑步（p<0.001）。
年轻、男性、高水平运动、不进行负重运动的运动员和 MacFL 手术可缩短 ACL 重建后运动恢复时间。
