Few young athletes meet newly derived age- and activity-relevant functional recovery targets after ACL reconstruction.
Few young athletes meet newly derived age- and activity-relevant functional recovery targets after ACL reconstruction.
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很少有年轻运动员在 ACL 重建后能够达到新制定的与年龄和活动相关的功能恢复目标。
DOI：
10.1007/s00167-021-06769-4
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发表时间：
2022
期刊：
影响因子：
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通讯作者：
Schmitt,LauraC
中科院分区：
文献类型：
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作者：
Ithurburn,MatthewP;Barenius,Björn;Thomas,Staci;Paterno,MarkV;Schmitt,LauraC
目的：国家注册数据建立了成人前交叉韧带（ACL）重建后膝关节损伤和骨关节炎结局评分（oos）功能恢复目标值。然而，对于ACL重建后的年轻运动员，这些目标值的特异性尚不清楚。该分析的目的是：(1)从未受伤的年轻运动员数据中得出与年龄和活动相关的oos功能恢复目标值；(2)确定与ACLR后年轻运动员的RTS清除相关的临床措施，以满足新得出的功能恢复目标值。方法222名年轻运动员（56名未受伤的对照组，17.2±2.4岁，73%为女性；166名ACL重建后的运动员，16.9±2.2岁，68%为女性）纳入一项大型队列研究的横断面分析。未受伤的对照组参与者完成oos，功能恢复目标值被定义为oos子量表95%置信区间的下界。ACL重建参与者在4周内完成了恢复运动的测试，包括oos、单腿跳跃测试和等长四头肌力量测试。在ACL重建参与者中，使用逻辑回归来确定满足人口学/损伤、跳跃和力量数据中所有oos功能恢复目定值（主要结局）的预测因子（α≤0.05）。结果未受伤运动员数据中各子量表的skoos功能恢复目标值为：疼痛≥94，症状≥92，日常生活活动≥97，运动≥92，生活质量≥92。在恢复运动时，ACL重建参与者达到oos功能恢复目标的比例如下：疼痛，63%；症状,42%;日常生活活动，80%；运动,45%;生活质量,24%;整体功能恢复（达到所有次级指标），17%。在ACL重建的参与者中，总体功能恢复（主要结果）的显著预测因素是：年龄更小，腘绳肌腱移植，儿童ACL重建，股四头肌力量四肢对称指数> 90%，单跳肢体对称指数> 90%，跨跳肢体对称指数> 90%。结论未受伤青年运动员的skoos功能恢复目标值高于文献报道。小比例的年轻运动员在ACLR后近期RTS清除后达到了这些新衍生的功能恢复目标值，与达到功能恢复目标值相关的因素包括年龄更小，腘绳肌腱自体移植和儿童ACLR，以及股四头肌力量和单腿跳跃测试的LSI为bbb90 %。证据水平。
PurposeNational registry data have established Knee injury and Osteoarthritis Outcome Score (KOOS) functional recovery target values for adults after anterior cruciate ligament (ACL) reconstruction. However, the specificity of these target values for young athletes after ACL reconstruction is unclear. The purpose of this analysis was to (1) derive age- and activity-relevant KOOS functional recovery target values from uninjured young athlete data and (2) determine clinical measures at the time of RTS clearance associated with meeting the newly-derived functional recovery target values in young athletes following ACLR.MethodsTwo hundred and twenty-two young athletes (56 uninjured controls, 17.2 ± 2.4 years, 73% female; 166 after ACL reconstruction, 16.9 ± 2.2 years, 68% female) were included in this cross-sectional analysis from a larger cohort study. Uninjured control participants completed the KOOS, and functional recovery target values were defined as the lower bound of the 95% confidence interval for KOOS subscales. ACL reconstruction participants completed testing within 4 weeks of return-to-sport clearance, including the KOOS, single-leg hop tests, and isometric quadriceps strength. In ACL reconstruction participants, logistic regression was used to determine predictors of meeting all KOOS functional recovery target values (primary outcome) among demographic/injury, hop, and strength data (α≤ 0.05).ResultsKOOS functional recovery target values for each subscale from uninjured athlete data were: Pain ≥ 94, Symptoms ≥ 92, Activities of Daily Living ≥ 97, Sport ≥ 92, and Quality-of-Life ≥ 92. At the time of return-to-sport clearance, ACL reconstruction participants met the KOOS functional recovery targets in the following proportions: Pain, 63%; Symptoms, 42%; Activities of Daily Living, 80%; Sport, 45%; Quality-of-Life, 24%; overall functional recovery (met all subscale targets), 17%. In ACL reconstruction participants, significant predictors of overall functional recovery (primary outcome) were: younger age, hamstring graft, pediatric ACL reconstruction, quadriceps strength limb-symmetry index > 90%, single-hop limb-symmetry index > 90%, and crossover-hop limb-symmetry index > 90%.ConclusionsKOOS functional recovery target values derived from uninjured young athletes were higher than those previously reported. Small proportions of young athletes following recent RTS clearance after ACLR met these newly-derived functional recovery target values, and factors associated with meeting functional recovery target values included younger age, hamstring autograft and pediatric ACLR, and having > 90% LSI for quadriceps strength and single-leg hop tests.Level of evidenceI.