Sabate-Ferris Alexandre, de l'Escalopier Nicolas, Barbier Olivier, Danis Julien, Demoures Thomas, Joly Benjamin, van Rooij Floris, Saffarini Mo, Choufani Camille
Clinic of Orthopedic, Traumatology and Reconstructive Surgery, Percy Military Teaching Hospital, Clamart, France.
Department of Surgery, Ecole du Val-de-Grâce, French Military Health Service Academy, Paris, France.
Int Orthop. 2024 Mar;48(3):675-681. doi: 10.1007/s00264-023-05964-x. Epub 2023 Sep 19.
To determine the rate and time of return to duty following anterior cruciate ligament reconstruction (ACLR) in military members, and to determine whether their outcomes are influenced by patient characteristics or surgical parameters.
We prospectively assessed 280 military members that underwent ACLR. 27 were excluded due to multi-ligamentous injuries or revision surgery, two did not provide informed consent and 62 were lost to follow-up. Patient demographics, pre-injury physical workload, complications and whether/when patients resumed duty and sports were noted, as well as clinical outcomes at a minimum follow-up of one year, including Knee Injury and Osteoarthritis Outcome Score (KOOS), International Knee Documentation Committee score (IKDC), Lysholm, and Tegner scale.
The final cohort of 189 military members (82% men) had mean age of 25.5 ± 3.4 (range,19-38) at ACLR. At 3.3 ± 1.6 years (range, 1.0-6.3), the Tegner score was 6.1 ± 2.0, Lysholm was 87.0 ± 13.7, IKDC was 80.1 ± 15.7, and KOOS was 81.1 ± 14.8. Only 144 patients (76%) resumed duty, at 9.5 ± 5.3 months (range,1-28), and 141 patients (75%) resumed sport, at 10.2 ± 6.2 months (range,1-35). Multivariable analysis revealed that return to duty was less likely in patients with higher BMI (OR,0.89;p = 0.025), but more likely in patients that followed military physiotherapy (OR,2.76;p = 0.017) and with higher pre-injury physical workload (OR,3.93;p = 0.010).
At a follow-up of 3.3 ± 1.6 years, 76% returned to duty at 9.5 ± 5.3 months, and 75% returned to their main sport at 10.2 ± 6.2 months. Patients with higher BMI are significantly less likely to resume military duty and sports; those that followed military physiotherapy were most likely to resume duty, while those that had greater pre-injury physical workload were more likely to both resume duty and sport.
确定军事人员前交叉韧带重建（ACLR）术后恢复执勤的比率和时间，并确定其结果是否受患者特征或手术参数的影响。
我们前瞻性评估了280名接受ACLR的军事人员。27人因多发韧带损伤或翻修手术被排除，2人未提供知情同意书，62人失访。记录患者人口统计学资料、伤前身体工作量、并发症以及患者是否/何时恢复执勤和运动，以及至少随访一年时的临床结果，包括膝关节损伤和骨关节炎疗效评分（KOOS）、国际膝关节文献委员会评分（IKDC）、Lysholm评分和Tegner量表。
最终队列中的189名军事人员（82%为男性）在进行ACLR时的平均年龄为25.5±3.4岁（范围19 - 38岁）。在3.3±1.6年（范围1.0 - 6.3年）时，Tegner评分为6.1±2.0，Lysholm评分为87.0±13.7，IKDC评分为80.1±15.7，KOOS评分为81.1±14.8。只有144名患者（76%）在9.5±5.3个月（范围1 - 28个月）时恢复执勤，141名患者（75%）在10.2±6.2个月（范围1 - 35个月）时恢复运动。多变量分析显示，BMI较高的患者恢复执勤的可能性较小（OR，0.89；p = 0.025），但接受军事物理治疗的患者恢复执勤的可能性较大（OR，2.76；p = 0.017），伤前身体工作量较高的患者也是如此（OR，3.93；p = 0.010）。
在3.3±1.6年的随访中，76%的患者在9.5±5.3个月时恢复执勤，75%的患者在10.2±6.2个月时恢复主要运动。BMI较高的患者恢复军事执勤和运动的可能性显著降低；接受军事物理治疗的患者恢复执勤的可能性最大，而伤前身体工作量较大的患者恢复执勤和运动的可能性均较大。
