Mark A. Glover B.S. , Jeffery D. St. Jeor M.D. , Nihir Parikh B.S. , Danielle E. Rider M.D. , Garrett S. Bullock D.P.T., D.Phil. , Nicholas A. Trasolini M.D. , Brian R. Waterman M.D.
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RTS was defined as participation in athletics at a level equivalent to or greater than the preinjury level participation. Demographic and prognostic factors, including previous knee surgery, meniscal involvement, level of participation, surgical approach, and graft type, were recorded along with RTS time and analyzed via Poisson regression.</p></div><div><h3>Results</h3><p>In total, 91 athletes, average age 18.8 (± 6.7) years, who underwent ACL reconstruction at a single institution from 2014 to 2021 were identified with an average follow-up time of 4.6 (± 2.5) years (range 1.1, 9.0). Meniscal involvement (1.11; 95% confidence interval [CI] 1.08-1.15, <em>P</em> < .001) and previous knee surgery (1.43; 95% CI 1.29-1.58; <em>P</em> < .001) were related to a delayed RTS. Quadriceps tendon and bone–patellar tendon–bone autografts, as well as allograft, showed a significant association with a longer RTS time when compared with hamstring autograft (1.16, 95% CI 1.13-1.20, <em>P</em> < .001; 1.04, 95% CI 1.01-1.07, <em>P</em> = .020; 1.11, 95% CI 1.03-1.19, <em>P</em> = .004, respectively), as did anteromedial portal drilling, when compared with the outside in approach for femoral drilling (1.19, 95% CI 1.16-1.23, <em>P</em> < .001).</p></div><div><h3>Conclusions</h3><p>Previous knee surgery, anteromedial femoral drilling, quadriceps tendon autograft, and meniscus tear were most associated with a delayed timeline for RTS among young athletes who were able to return.</p></div><div><h3>Level of Evidence</h3><p>Level IV, prognostic case series.</p></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666061X24000294/pdfft?md5=e741866ffbc3e96342e1bba123f83a04&pid=1-s2.0-S2666061X24000294-main.pdf","citationCount":"0","resultStr":"{\"title\":\"Previous Knee Surgery, Anteromedial Portal Drilling, Quadriceps Tendon Autograft, and Meniscal Involvement Associated With Delayed Return to Sport After Anterior Cruciate Ligament Reconstruction in Amateur Athletes\",\"authors\":\"Mark A. Glover B.S. , Jeffery D. St. Jeor M.D. , Nihir Parikh B.S. , Danielle E. Rider M.D. , Garrett S. Bullock D.P.T., D.Phil. , Nicholas A. Trasolini M.D. , Brian R. Waterman M.D.\",\"doi\":\"10.1016/j.asmr.2024.100911\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Purpose</h3><p>To identify prognostic factors associated with a delayed return-to-sport (RTS) time in amateur athletes who return to full participation after a primary isolated anterior cruciate ligament (ACL) reconstruction.</p></div><div><h3>Methods</h3><p>A retrospective review was performed among athletes who underwent ACL reconstruction between October 2014 and October 2021. Inclusion criteria were any amateur athletes with an ACL reconstruction who had a documented RTS and greater than 1-year follow-up. Nonathletes, those with multiligamentous knee injury, and those missing documented RTS timelines were excluded. RTS was defined as participation in athletics at a level equivalent to or greater than the preinjury level participation. Demographic and prognostic factors, including previous knee surgery, meniscal involvement, level of participation, surgical approach, and graft type, were recorded along with RTS time and analyzed via Poisson regression.</p></div><div><h3>Results</h3><p>In total, 91 athletes, average age 18.8 (± 6.7) years, who underwent ACL reconstruction at a single institution from 2014 to 2021 were identified with an average follow-up time of 4.6 (± 2.5) years (range 1.1, 9.0). Meniscal involvement (1.11; 95% confidence interval [CI] 1.08-1.15, <em>P</em> < .001) and previous knee surgery (1.43; 95% CI 1.29-1.58; <em>P</em> < .001) were related to a delayed RTS. Quadriceps tendon and bone–patellar tendon–bone autografts, as well as allograft, showed a significant association with a longer RTS time when compared with hamstring autograft (1.16, 95% CI 1.13-1.20, <em>P</em> < .001; 1.04, 95% CI 1.01-1.07, <em>P</em> = .020; 1.11, 95% CI 1.03-1.19, <em>P</em> = .004, respectively), as did anteromedial portal drilling, when compared with the outside in approach for femoral drilling (1.19, 95% CI 1.16-1.23, <em>P</em> < .001).</p></div><div><h3>Conclusions</h3><p>Previous knee surgery, anteromedial femoral drilling, quadriceps tendon autograft, and meniscus tear were most associated with a delayed timeline for RTS among young athletes who were able to return.</p></div><div><h3>Level of Evidence</h3><p>Level IV, prognostic case series.</p></div>\",\"PeriodicalId\":34631,\"journal\":{\"name\":\"Arthroscopy Sports Medicine and Rehabilitation\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2024-06-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.sciencedirect.com/science/article/pii/S2666061X24000294/pdfft?md5=e741866ffbc3e96342e1bba123f83a04&pid=1-s2.0-S2666061X24000294-main.pdf\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Arthroscopy Sports Medicine and Rehabilitation\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2666061X24000294\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Arthroscopy Sports Medicine and Rehabilitation","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2666061X24000294","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"Medicine","Score":null,"Total":0}
引用次数: 0
摘要
目的 找出业余运动员在接受原发性孤立前交叉韧带（ACL）重建术后重返赛场（RTS）时间延迟的相关预后因素。方法 对 2014 年 10 月至 2021 年 10 月间接受前交叉韧带重建术的运动员进行回顾性研究。纳入标准是所有接受过前交叉韧带重建术的业余运动员，他们都有RTS记录，且随访时间超过1年。非运动员、膝关节多韧带损伤者和缺少有记录的 RTS 时间线者被排除在外。RTS的定义是参与运动的水平相当于或高于受伤前的参与水平。人口统计学和预后因素，包括既往膝关节手术、半月板受累情况、参与水平、手术方式和移植物类型，均与RTS时间一并记录，并通过泊松回归进行分析。结果在2014年至2021年期间，共有91名平均年龄为18.8（±6.7）岁的运动员在一家机构接受了前交叉韧带重建手术，平均随访时间为4.6（±2.5）年（范围为1.1-9.0）。半月板受累（1.11；95% 置信区间 [CI] 1.08-1.15，P <.001）和既往膝关节手术（1.43；95% CI 1.29-1.58；P <.001）与延迟 RTS 有关。与腘绳肌自体移植物相比，股四头肌腱和骨-髌腱-骨自体移植物以及同种异体移植物与较长的 RTS 时间有显著相关性（1.16，95% CI 1.13-1.20，P < .001；1.04，95% CI 1.01-1.07，P = .020；1.11，95% CI 1.03-1.19，P = .004）。19，95% CI 1.16-1.23，P <.001）。结论在能够重返赛场的年轻运动员中，先前的膝关节手术、股骨内侧前门钻孔、股四头肌腱自体移植和半月板撕裂与RTS的时间延迟最为相关。
Previous Knee Surgery, Anteromedial Portal Drilling, Quadriceps Tendon Autograft, and Meniscal Involvement Associated With Delayed Return to Sport After Anterior Cruciate Ligament Reconstruction in Amateur Athletes
Purpose
To identify prognostic factors associated with a delayed return-to-sport (RTS) time in amateur athletes who return to full participation after a primary isolated anterior cruciate ligament (ACL) reconstruction.
Methods
A retrospective review was performed among athletes who underwent ACL reconstruction between October 2014 and October 2021. Inclusion criteria were any amateur athletes with an ACL reconstruction who had a documented RTS and greater than 1-year follow-up. Nonathletes, those with multiligamentous knee injury, and those missing documented RTS timelines were excluded. RTS was defined as participation in athletics at a level equivalent to or greater than the preinjury level participation. Demographic and prognostic factors, including previous knee surgery, meniscal involvement, level of participation, surgical approach, and graft type, were recorded along with RTS time and analyzed via Poisson regression.
Results
In total, 91 athletes, average age 18.8 (± 6.7) years, who underwent ACL reconstruction at a single institution from 2014 to 2021 were identified with an average follow-up time of 4.6 (± 2.5) years (range 1.1, 9.0). Meniscal involvement (1.11; 95% confidence interval [CI] 1.08-1.15, P < .001) and previous knee surgery (1.43; 95% CI 1.29-1.58; P < .001) were related to a delayed RTS. Quadriceps tendon and bone–patellar tendon–bone autografts, as well as allograft, showed a significant association with a longer RTS time when compared with hamstring autograft (1.16, 95% CI 1.13-1.20, P < .001; 1.04, 95% CI 1.01-1.07, P = .020; 1.11, 95% CI 1.03-1.19, P = .004, respectively), as did anteromedial portal drilling, when compared with the outside in approach for femoral drilling (1.19, 95% CI 1.16-1.23, P < .001).
Conclusions
Previous knee surgery, anteromedial femoral drilling, quadriceps tendon autograft, and meniscus tear were most associated with a delayed timeline for RTS among young athletes who were able to return.
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