Butler Lauren, Martinez Alexa, Entessari Mina, Cardenas Gabriel, Wright Margaret, Sugimoto Dai
Florida International University, Miami, Florida, USA.
Nicklaus Children's Hospital, Miami, Florida, USA.
BMJ Open Sport Exerc Med. 2024 Aug 3;10(3):e002000. doi: 10.1136/bmjsem-2024-002000. eCollection 2024.
To determine risk factors for second anterior cruciate ligament (ACL) injury following primary ACL reconstruction (ACLR) using return-to-sport (RTS) tests consisting of qualitative and quantitative measures in young athletes.
A case-control study design was used, and a retrospective review of adolescent athletes after primary ACLR was performed. All athletes completed an RTS test consisting of qualitative and quantitative assessments and psychological assessments with the Tampa Scale of Kinesiophobia. Athlete demographics, surgical characteristics and sports participation were also examined. A binary logistic regression was performed to verify an independent association between risk factors and second ACL injury using adjusted OR (aORs), 95% CI and p<0.05.
In 72 eligible athletes, 12 (16.7%) suffered a second ACL injury. The mean Tegner activity level was 8.4+1.1, and the mean time from ACLR to RTS test completion was 10.4+2.9 months. One variable that showed the lowest p-value in the preliminary analysis was entered into the binary logistic regression model, which resulted in that qualitative assessment of knee valgus during the sidestep cut was associated with second ACL injury (aOR=4.64, 95% CI: 1.18 to 18.23, p=0.03).
Athletes who demonstrated excessive dynamic knee valgus on the involved limb during the sidestep cut were approximately 4.6 times more likely to suffer a second ACL injury.
通过对年轻运动员进行包括定性和定量指标的重返运动（RTS）测试，确定初次前交叉韧带重建（ACLR）后发生二次前交叉韧带（ACL）损伤的危险因素。
采用病例对照研究设计，对初次ACL重建后的青少年运动员进行回顾性分析。所有运动员均完成了一项RTS测试，包括定性和定量评估以及使用坦帕运动恐惧量表进行的心理评估。还对运动员的人口统计学特征、手术特点和运动参与情况进行了检查。采用二元逻辑回归分析，使用校正比值比（aORs）、95%置信区间（CI）和p<0.05来验证危险因素与二次ACL损伤之间的独立关联。
在72名符合条件的运动员中，12名（16.7%）发生了二次ACL损伤。平均Tegner活动水平为8.4±1.1，从ACLR到完成RTS测试的平均时间为10.4±2.9个月。将初步分析中p值最低的一个变量纳入二元逻辑回归模型，结果显示，侧步切入时患侧膝关节外翻的定性评估与二次ACL损伤相关（aOR=4.64，95%CI：1.18至18.23，p=0.03）。
在侧步切入时患侧肢体出现过度动态膝关节外翻的运动员发生二次ACL损伤的可能性约为4.6倍。
