Sanford Orthopedics and Sports Medicine Research, Sanford Health, Fargo, ND.
Department of Biomedical Engineering.
J Athl Train. 2024 Sep 1;59(9):898-905. doi: 10.4085/1062-6050-0189.23.
CONTEXT: Low scores on psychological patient-reported outcomes measures, including the Anterior Cruciate Ligament-Return to Sport After Injury (ACL-RSI) and Injury-Psychological Readiness to Return to Sport (I-PRRS), after anterior cruciate ligament reconstruction (ACLR) have been associated with a maladaptive psychological response to injury and poor prognosis. OBJECTIVE: To assess the effect of time post-ACLR and sex on ACL-RSI and I-PRRS scores and generate normative reference curves. DESIGN: Case series. SETTING: Outpatient sports medicine and orthopaedic clinic. PATIENTS OR OTHER PARTICIPANTS: A total of 507 patients (age at ACLR, 17.9 ± 3.0 years) who had undergone primary ACLR and completed ACL-RSI or I-PRRS assessments ≥1 times (n = 796) between 0 and 1 year post-ACLR. MAIN OUTCOME MEASURE(S): An honest broker provided anonymous data from our institution's knee-injury clinical database. Generalized additive models for location, scale, and shape and generalized least-squares analyses were used to assess the effect of time post-ACLR and sex on ACL-RSI and I-PRRS scores. RESULTS: The ACL-RSI and I-PRRS scores increased over time post-ACLR. Males had higher scores than females until approximately 5 months post-ACLR, with scores converging thereafter. CONCLUSIONS: Males reported higher ACL-RSI and I-PRRS scores than females in the initial stages of rehabilitation, but scores converged between sexes at times associated with return to play post-ACLR. Normative reference curves can be used to objectively appraise ACL-RSI and I-PRRS scores at any time post-ACLR. This may lead to timely recognition of patients with a maladaptive psychological response to injury and a higher likelihood of a poor prognosis, optimizing ACLR outcomes.
背景:前交叉韧带重建(ACL)后,心理患者报告结局测量(包括前交叉韧带损伤后重返运动的 ACL 评分 [ACL-RSI] 和损伤后重返运动的心理准备状态评分 [I-PRRS])得分较低与对损伤的适应不良的心理反应和不良预后有关。
目的:评估 ACLR 后时间和性别对 ACL-RSI 和 I-PRRS 评分的影响,并生成正常参考曲线。
设计:病例系列。
设置:门诊运动医学和矫形诊所。
患者或其他参与者:共 507 名患者(ACL 重建时年龄为 17.9 ± 3.0 岁),他们在 ACLR 后 0 至 1 年内至少进行了 1 次 ACL-RSI 或 I-PRRS 评估(n = 796)。
主要观察指标:一位诚实的中间人从我们机构的膝关节损伤临床数据库中提供了匿名数据。使用位置、规模和形状的广义加性模型和广义最小二乘分析来评估 ACLR 后时间和性别对 ACL-RSI 和 I-PRRS 评分的影响。
结果:ACL-RSI 和 I-PRRS 评分随 ACLR 后时间的推移而增加。男性的评分高于女性,直到 ACLR 后大约 5 个月,此后评分趋于一致。
结论:在康复的初始阶段,男性报告的 ACL-RSI 和 I-PRRS 评分高于女性,但在与 ACLR 后重返比赛相关的时间点,男女之间的评分趋于一致。正常参考曲线可用于在 ACLR 后任何时间客观评估 ACL-RSI 和 I-PRRS 评分。这可能导致及时识别对损伤适应不良的患者,并提高预后不良的可能性,从而优化 ACLR 结果。
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