Incidence of contralateral and ipsilateral anterior cruciate ligament (ACL) injury after primary ACL reconstruction and return to sport.
Incidence of contralateral and ipsilateral anterior cruciate ligament (ACL) injury after primary ACL reconstruction and return to sport.
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DOI：
10.1097/jsm.0b013e318246ef9e
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发表时间：
2012-03
期刊：
影响因子：
--
通讯作者：
Hewett TE
中科院分区：
文献类型：
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作者：
Paterno MV;Rauh MJ;Schmitt LC;Ford KR;Hewett TE
前交叉韧带重建（ACLR）后同侧或对侧损伤的发生率（IR）未知。假设ACLR后前交叉韧带（ACL）损伤的IR将大于未受伤运动员队列的IR，并且ACLR后女性运动员的IR将大于男性运动员。前瞻性病例对照研究。区域体育社区。63名患有ACLR并准备恢复运动（RTS）的受试者和39名对照受试者。第二次ACL损伤和性别。第二次ACL损伤和运动暴露（AE）在RTS后跟踪12个月。ACLR后16例受试者和1例对照受试者发生第二次ACL损伤。对第二次ACL损伤发生率（每1000起AE）进行组间和组内比较。ACLR后ACL损伤的IR（1.82/1000 AE）是对照组（0.12/1000 AE）的15倍[风险比（RR）= 15.24; P = 0.0002）。女性ACLR运动员的受伤率比女性对照组高16倍（RR = 16.02; P = 0.0002）。女性运动员发生第二次ACL损伤的可能性是男性运动员的4倍（RR = 3.65; P = 0.05），发生对侧损伤的可能性是男性运动员的6倍（RR = 6.21; P = 0.04）。与健康人群相比，运动员ACLR后第二次ACL损伤的发生率增加。女性运动员遭受对侧ACL损伤的比率高于男性运动员，并且似乎遭受对侧ACL损伤的频率高于移植物再撕裂。在ACLR运动员人群中识别高危人群是改善ACLR和RTS后结果的关键步骤。
Incidence rate (IR) of an ipsilateral or contralateral injury after anterior cruciate ligament reconstruction (ACLR) is unknown. The hypotheses were that the IR of anterior cruciate ligament (ACL) injury after ACLR would be greater than the IR in an uninjured cohort of athletes and would be greater in female athletes after ACLR than male athletes. Prospective case–control study. Regional sports community. Sixty-three subjects who had ACLR and were ready to return to sport (RTS) and 39 control subjects. Second ACL injury and sex. Second ACL injury and athletic exposure (AE) was tracked for 12 months after RTS. Sixteen subjects after ACLR and 1 control subject suffered a second ACL injury. Between- and within-group comparisons of second ACL injury rates (per 1000 AEs) were conducted. The IR of ACL injury after ACLR (1.82/1000 AE) was 15 times greater [risk ratio (RR) = 15.24; P = 0.0002) than that of control subjects (0.12/1000AE). Female ACLR athletes demonstrated 16 times greater rate of injury (RR = 16.02; P = 0.0002) than female control subjects. Female athletes were 4 (RR = 3.65; P = 0.05) times more likely to suffer a second ACL injury and 6 times (RR = 6.21; P = 0.04) more likely to suffer a contralateral injury than male athletes. An increased rate of second ACL injury after ACLR exists in athletes when compared with a healthy population. Female athletes suffer contralateral ACL injuries at a higher rate than male athletes and seem to suffer contralateral ACL injuries more frequently than graft re-tears. The identification of a high-risk group within a population of ACLR athletes is a critical step to improve outcome after ACLR and RTS.