Mercurio Michele, Cerciello Simone, Corona Katia, Guerra Germano, Simonetta Roberto, Familiari Filippo, Galasso Olimpio, Gasparini Giorgio
Department of Orthopaedic and Trauma Surgery, Magna Græcia University, Mater Domini University Hospital, Catanzaro, Italy.
Department of Life Sciences, Health and Health Professions, Link Campus University, Rome, Italy.
Orthop J Sports Med. 2024 Oct 8;12(10):23259671241275663. doi: 10.1177/23259671241275663. eCollection 2024 Oct.
Anterior cruciate ligament reconstruction (ACLR) is highly recommended in patients with ACL deficiency who must perform at a high physical level. A combination of functional and psychological outcome measures is necessary to provide a comprehensive evaluation of functional status after successful return to sport after ACLR.
To identify factors associated with higher functional outcomes among soccer players who had returned to full sports participation after ACLR.
Cohort study; Level of evidence, 3.
A total of 168 out of 231 patients who underwent primary unilateral arthroscopic anatomic single-bundle ACLR were available at follow-up. Postoperatively, knee function, generic health outcomes, and psychological impact were assessed using the International Knee Documentation Committee (IKDC), the Knee injury and Osteoarthritis Outcome Score (KOOS), the Lysholm Knee Scoring Scale, the 12-item Short Form Health Survey (SF-12), and the ACL-Return to Sport after Injury scale.
After a mean follow-up of 35.5 ± 22.6 months, 85% of soccer players returned to performance. Midfielder position was associated with a better SF-12 Physical Component Summary (PCS) score ( = .013), IKDC ( = .003), total KOOS ( < .001), KOOS Symptoms ( = .004), KOOS Pain ( = .029), KOOS Activities of Daily Living (ADL) ( = .044), KOOS Sport and Recreation (Sport/Rec) ( = .001), KOOS Quality of Life (QoL) ( < .001), and Lysholm score ( = .008). Playing only on natural grass was associated with lower SF-12 PCS scores ( = .003), total KOOS ( = .001), and KOOS Sport/Rec ( = .011). Playing only on artificial turf was associated with lower Lysholm score ( = .018) and total KOOS ( = .014). The contact mechanism was associated with higher IKDC ( = .044) and KOOS QoL ( = .048), and injury affecting the dominant limb was associated with lower SF-12 Mental Component Summary scores ( = .012). Playing at a nonprofessional level was associated with lower total KOOS ( = .028), KOOS Symptoms ( = .002), KOOS ADL ( = .033), and KOOS Sport/Rec ( = .016).
Professional soccer players and the midfielder position are associated with better functional scores upon returning to the sport. A history of noncontact ACL injury and playing on a single type of surface are associated with lower functional outcomes upon returning to the sport. Lower mental health scores can be expected after injury of the dominant limb.
对于必须进行高水平体育活动的前交叉韧带损伤（ACLR）患者，强烈建议进行前交叉韧带重建术。功能和心理结局指标相结合对于全面评估ACLR术后成功恢复运动后的功能状态很有必要。
确定ACLR术后恢复全面体育活动的足球运动员中与更高功能结局相关的因素。
队列研究；证据等级，3级。
231例行初次单侧关节镜解剖单束ACLR的患者中，共有168例在随访时可用。术后，使用国际膝关节文献委员会（IKDC）、膝关节损伤和骨关节炎结局评分（KOOS）、Lysholm膝关节评分量表、12项简短健康调查（SF-12）以及ACL损伤后恢复运动量表评估膝关节功能、一般健康结局和心理影响。
平均随访35.5±22.6个月后，85%的足球运动员恢复了比赛。中场球员位置与更好的SF-12身体成分总结（PCS）评分（P = 0.013）、IKDC（P = 0.003）、总KOOS（P < 0.001）、KOOS症状（P = 0.004）、KOOS疼痛（P = 0.029）、KOOS日常生活活动（ADL）（P = 0.044）、KOOS运动和娱乐（运动/娱乐）（P = 0.001）、KOOS生活质量（QoL）（P < 0.001）以及Lysholm评分（P = 0.008）相关。仅在天然草坪上比赛与较低的SF-12 PCS评分（P = 0.003）、总KOOS（P = 0.001）和KOOS运动/娱乐（P = 0.011）相关。仅在人工草皮上比赛与较低的Lysholm评分（P = 0.018）和总KOOS（P = 0.014）相关。接触机制与更高的IKDC（P = 0.044）和KOOS QoL（P = 0.048）相关，影响优势肢体的损伤与较低的SF-12心理成分总结评分（P = 0.012）相关。在非职业水平比赛与较低的总KOOS（P = 0.028）、KOOS症状（P = 0.002）、KOOS ADL（P = 0.033）和KOOS运动/娱乐（P = 0.016）相关。
职业足球运动员和中场球员位置与恢复运动后的功能评分较好相关。非接触性ACL损伤史和在单一类型场地比赛与恢复运动后的功能结局较低相关。优势肢体受伤后心理健康评分可能较低。
