Incidence of Second ACL Injuries 2 Years After Primary ACL Reconstruction and Return to Sport.
Incidence of Second ACL Injuries 2 Years After Primary ACL Reconstruction and Return to Sport.
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DOI：
10.1177/0363546514530088
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发表时间：
2014-07
期刊：
影响因子：
--
通讯作者：
Hewett TE
中科院分区：
文献类型：
--
作者：
Paterno MV;Rauh MJ;Schmitt LC;Ford KR;Hewett TE
据报道，在年轻活跃人群中，ACL重建（ACLR）和恢复运动（RTS）后的前12个月内，第二次前交叉韧带（ACL）损伤的发生率是先前未受伤队列的15倍。没有报告估计这种高相对伤害率是否持续超过RTS和ACLR后的第一年。ACLR和RTS后2年内ACL损伤的发生率低于RTS后前12个月内报告的发生率，但高于未受伤年轻运动员队列中ACL损伤的发生率。队列研究;证据等级，2。前瞻性入组了78例接受ACLR并准备恢复旋转/切割运动的患者（平均年龄，17.1 ± 3.1岁）和47例也参与旋转/切割运动的对照组（平均年龄，17.2 ± 2.6岁）。在RTS后的24个月内，对每位参与者进行了伤害和运动员暴露（AE）数据的随访。在此期间，23名ACLR参与者和4名对照参与者发生ACL损伤。计算发生率比（IRR），以比较ACLR组和对照组运动员ACL损伤的发生率（每1000起AE）。对于ACLR组，按性别对损伤侧进行了类似的比较。ACLR和RTS后24个月内第二次ACL损伤的总体发生率（1.39/1000起AE）几乎是健康对照受试者（0.24/1000起AE）的6倍（IRR，5.71; 95% CI，2.0-22.7; P = 0.0003）。ACLR组女性运动员RTS 24个月内的损伤率几乎是女性对照组的5倍（IRR，4.51; 95% CI，1.5-18.2; P = .0004）。虽然仅观察到一种趋势，但ACLR组中女性患者发生对侧损伤（1.13/1000起AE）的可能性是同侧损伤（0.47/1000起AE）的两倍（IRR，2.43; 95% CI，0.8-8.6）。总体而言，29.5%的运动员在RTS后24个月内发生了第二次ACL损伤，20.5%的运动员发生了对侧损伤，9.0%的运动员发生了同侧移植物的再撕裂损伤。女性参与者（23.7%）遭受对侧损伤的比例高于男性参与者（10.5%）（P = 0.18）。相反，对于同侧损伤，女性（8.5%）和男性（10.5%）参与者的发病率比例相似。这些数据支持以下假设：在ACLR和RTS后的24个月内，与没有ACL损伤史的年轻运动员相比，患者遭受后续ACL损伤的风险更大。此外，女性患者的对侧肢体出现的风险最大。
The incidence of second anterior cruciate ligament (ACL) injuries in the first 12 months after ACL reconstruction (ACLR) and return to sport (RTS) in a young, active population has been reported to be 15 times greater than that in a previously uninjured cohort. There are no reported estimates of whether this high relative rate of injury continues beyond the first year after RTS and ACLR. The incidence rate of a subsequent ACL injury in the 2 years after ACLR and RTS would be less than the incidence rate reported within the first 12 months after RTS but greater than the ACL injury incidence rate in an uninjured cohort of young athletes. Cohort study; Level of evidence, 2. Seventy-eight patients (mean age, 17.1 ± 3.1 years) who underwent ACLR and were ready to return to a pivoting/ cutting sport and 47 controls (mean age, 17.2 ± 2.6 years) who also participated in pivoting/cutting sports were prospectively enrolled. Each participant was followed for injury and athlete exposure (AE) data for a 24-month period after RTS. Twenty-three ACLR and 4 control participants suffered an ACL injury during this time. Incidence rate ratios (IRRs) were calculated to compare the rates (per 1000 AEs) of ACL injury in athletes in the ACLR and control groups. For the ACLR group, similar comparisons were conducted for side of injury by sex. The overall incidence rate of a second ACL injury within 24 months after ACLR and RTS (1.39/1000 AEs) was nearly 6 times greater (IRR, 5.71; 95% CI, 2.0–22.7; P = .0003) than that in healthy control participants (0.24/1000 AEs). The rate of injury within 24 months of RTS for female athletes in the ACLR group was almost 5 times greater (IRR, 4.51; 95% CI, 1.5–18.2; P = .0004) than that for female controls. Although only a trend was observed, female patients within the ACLR group were twice as likely (IRR, 2.43; 95% CI, 0.8–8.6) to suffer a contralateral injury (1.13/1000 AEs) than an ipsilateral injury (0.47/1000 AEs). Overall, 29.5% of athletes suffered a second ACL injury within 24 months of RTS, with 20.5% sustaining a contralateral injury and 9.0% incurring a retear injury of the ipsilateral graft. There was a trend toward a higher proportion of female participants (23.7%) who suffered a contralateral injury compared with male participants (10.5%) (P = .18). Conversely, for ipsilateral injuries, the incidence proportion between female (8.5%) and male (10.5%) participants was similar. These data support the hypothesis that in the 24 months after ACLR and RTS, patients are at a greater risk to suffer a subsequent ACL injury compared with young athletes without a history of ACL injuries. In addition, the contralateral limb of female patients appears at greatest risk.
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影响因子：
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DOI：
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发表时间：
2012-09
期刊：
The Journal of orthopaedic and sports physical therapy
影响因子：
--
作者：
Schmitt LC;Paterno MV;Hewett TE
通讯作者：
Hewett TE
影响因子：
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作者：
Paterno, Mark V.;Schmitt, Laura C.;Hewett, Timothy E.
通讯作者：
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