前十字韧带损伤不会增加未来发生脑震荡的风险:单向现象。

IF 1.3 4区 医学 Q3 REHABILITATION Journal of Sport Rehabilitation Pub Date : 2024-09-25 DOI:10.1123/jsr.2024-0030
April L McPherson, Dirk R Larson, Matthew B Shirley, Malik E Dancy, Nathaniel A Bates, Nathan D Schilaty
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引用次数: 0

摘要

背景:流行病学研究表明,脑震荡后肌肉骨骼损伤的风险增加。本研究的目的是确定是否存在相反的关系,特别是在以人群为基础的队列中,前十字韧带(ACL)损伤后脑震荡的风险是否会增加:设计:回顾性队列:方法:在 2000 年至 2017 年期间,在罗切斯特流行病学项目(Rochester Epidemiology Project)中搜索与脑震荡和前十字韧带撕裂的诊断和治疗相关的国际疾病分类第 9 版和第 10 版代码。共确定了1294名既往无脑震荡病史的急性、孤立性前交叉韧带撕裂患者。对病例的医疗记录进行审查,以确认前交叉韧带撕裂的诊断,并确定前交叉韧带损伤后的脑震荡病史。根据年龄、性别和罗切斯特流行病学项目(Rochester Epidemiology Project)的可用性,将病例与未发生前十字韧带撕裂的患者进行匹配(1:3 匹配),得出 3882 例对照组患者。对匹配的对照组患者的病历进行了审查,以排除前交叉韧带损伤史。确定了前交叉韧带损伤后脑震荡损伤的危险比:结果:9 名前交叉韧带损伤患者在前交叉韧带损伤后 3 年内出现脑震荡。前交叉韧带损伤病例的脑震荡发生率(0.7%)与无前交叉韧带损伤的匹配对照组(1.2%)相比没有差异,危险比为 0.55(95% 置信区间,0.3-1.1;P = .10):根据目前的证据,前交叉韧带损伤与后续脑震荡之间似乎没有明显的关联,这表明脑震荡对未来后续肌肉骨骼损伤的风险具有独特的影响。
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Anterior Cruciate Ligament Injury Does Not Increase the Risk for a Future Concussion: A Unidirectional Phenomenon.

Context: Epidemiological studies have shown an increased risk of musculoskeletal injury after concussion. The purpose of this study was to determine whether the reverse relationship exists, specifically whether there is an increased risk of concussion after an anterior cruciate ligament (ACL) injury in a population-based cohort.

Design: Retrospective cohort.

Methods: The Rochester Epidemiology Project was searched between 2000 and 2017 for International Classification of Diseases, 9th and 10th Revision codes relevant to the diagnosis and treatment of concussion and ACL tear. A total of 1294 unique patients with acute, isolated ACL tears and no previous history of concussion were identified. Medical records for cases were reviewed to confirm ACL tear diagnosis and to determine history of concussion after the ACL injury. Cases were matched by age, sex, and Rochester Epidemiology Project availability to patients without an ACL tear (1:3 match), resulting in 3882 controls. Medical records of matched control patients were reviewed to rule out history of ACL injury. The hazard ratio of concussion injury following an ACL injury was determined.

Results: Nine patients with an ACL injury suffered concussion up to 3 years after the ACL injury. The rate of concussion was no different between ACL-injured cases (0.7%) compared with matched controls with no ACL injury (1.2%), which corresponded to a hazard ratio of 0.55 (95% confidence interval, 0.3-1.1; P = .10).

Conclusions: Based on the current evidence, there does not appear to be a significant association between ACL injury and subsequent concussion, which suggests that a concussion uniquely affects the risk of future subsequent musculoskeletal injury.

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来源期刊
Journal of Sport Rehabilitation
Journal of Sport Rehabilitation 医学-康复医学
CiteScore
3.20
自引率
5.90%
发文量
143
审稿时长
>12 weeks
期刊介绍: The Journal of Sport Rehabilitation (JSR) is your source for the latest peer-reviewed research in the field of sport rehabilitation. All members of the sports-medicine team will benefit from the wealth of important information in each issue. JSR is completely devoted to the rehabilitation of sport and exercise injuries, regardless of the age, gender, sport ability, level of fitness, or health status of the participant. JSR publishes peer-reviewed original research, systematic reviews/meta-analyses, critically appraised topics (CATs), case studies/series, and technical reports that directly affect the management and rehabilitation of injuries incurred during sport-related activities, irrespective of the individual’s age, gender, sport ability, level of fitness, or health status. The journal is intended to provide an international, multidisciplinary forum to serve the needs of all members of the sports medicine team, including athletic trainers/therapists, sport physical therapists/physiotherapists, sports medicine physicians, and other health care and medical professionals.
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