足球是世界上最常见的团队运动,也是前交叉韧带(ACL)损伤和随后的ACL重建(ACLR)的高风险运动。
评估在澳大利亚足球受伤后接受自体腿筋肌腱移植的ACLR患者进一步ACL损伤的发生率,并确定与重复ACL损伤和重返足球相关的因素。
病例对照研究;证据水平,3.
从前瞻性收集的数据库中,确定了在足球运动员中使用腿筋自体移植物进行的一系列1000次连续ACLR。在重建后至少5年对患者进行了调查,包括任何一个膝盖进一步的ACL损伤的细节,回到足球或其他运动,根据前交叉韧带受伤后恢复运动(ACL-RSI)量表的心理准备。
在862名参与者中,重建后5年内发生ACL移植物破裂85例(10%),对侧ACL破裂68例(8%)。女性的5年ACL移植物存活率为94%,男性为88%。男性对侧ACL的存活率为92%,女性为90%。与年龄>25岁的人相比,19~25岁人群发生ACL移植物破裂的几率增加4~5倍,≤18岁人群发生ACL移植物破裂的几率增加3~7倍.44%的年龄≤18岁的男性进一步损伤移植物或对侧膝关节的ACL。进一步ACL损伤的危险因素是手术时年龄较小,男性,回到足球。移植物直径不影响ACL移植物破裂率,70%的患者在ACLR后重返足球运动。ACL-RSI平均得分为59分,并且报告这种规模的患者对再受伤的恐惧程度较低。
在这个主要是娱乐性的澳大利亚足球运动员的大队列中,ACL移植物破裂(10%)和对侧ACL破裂(8%)的患病率在5年内几乎相等。自体肌腱移植的ACLR是一种可靠的手术,允许70%的患者在这个高风险人群中重返足球运动。进一步ACL损伤的危险因素是手术时年龄逐渐年轻,男性,回到足球。移植物直径不是ACL移植物破裂的因素,表明其他因素,尤其是年龄,是最重要的。
Soccer is the most commonly played team sport in the world and a high-risk sport for anterior cruciate ligament (ACL) injury and subsequent ACL reconstruction (ACLR).
To assess the rate of further ACL injury in patients who have undergone ACLR with hamstring tendon autograft after soccer injuries in Australia and to determine factors associated with repeat ACL injury and return to soccer.
Case-control study; Level of evidence, 3.
From a prospectively collected database, a series of 1000 consecutive ACLRs using hamstring autografts performed in soccer players were identified. Patients were surveyed at a minimum 5 years after reconstruction, including details of further ACL injuries to either knee, return to soccer or other sports, and psychological readiness per the Anterior Cruciate Ligament Return to Sport after Injury (ACL-RSI) scale.
Of the 862 participants reviewed, ACL graft rupture occurred in 85 (10%) and contralateral ACL rupture in 68 (8%) within 5 years after the reconstruction. The 5-year ACL graft survivorship was 94% for females and 88% for males. The survivorship of the contralateral ACL was 92% for males and 90% for females. When compared with those aged >25 years, the odds of ACL graft rupture was increased by 4 to 5 times in those aged 19 to 25 years and 3 to 7 times in those ≤18 years. Further ACL injury to the graft or contralateral knee occurred in 44% of males aged ≤18 years. Risk factors for further ACL injury were younger age at time of surgery, male sex, and return to soccer. Graft diameter did not influence ACL graft rupture rates, and 70% of patients returned to soccer after ACLR. The mean ACL-RSI score was 59, and patients who reported more fear of reinjury on this scale were less likely to have returned to soccer.
The prevalence of ACL graft rupture (10%) and contralateral ACL rupture (8%) was near equivalent over 5 years in this large cohort of mostly recreational Australian soccer players. ACLR with hamstring autograft is a reliable procedure, allowing 70% of patients to return to soccer in this high-risk population. Risk factors for further ACL injury are progressively younger age at time of surgery, male sex, and return to soccer. Graft diameter was not a factor in ACL graft rupture, indicating that other factors, particularly age, are of primary importance.