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首页> 外文期刊>Orthopaedic Journal of Sports Medicine >ACL GRAFT FAILURE IN PROFESSIONAL ATHLETES COMPARED TO THE PEDIATRIC POPULATION
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ACL GRAFT FAILURE IN PROFESSIONAL ATHLETES COMPARED TO THE PEDIATRIC POPULATION

机译：与小儿人口比较的专业运动员的ACL移植失败

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BACKGROUND Re-tear rates in pediatric and adolescent patients undergoing ACL reconstruction are higher than the general adult population. This has been postulated to be due to many reasons; one of which is participation in high risk activities. Athletes in professional sports are at increased risk of re-injury as well with high activity levels and often face additional pressure to return to sports quickly. The purpose of the study was to analyze ACL re-tear rates across male professional sports leagues in athletes following ACL reconstruction and return to play at the professional level to determine if there are similarities with the pediatric and adolescent population. METHODS This descriptive epidemiological study involved a comprehensive online search to identify male athletes in the National Basketball Association (NBA), National Hockey League (NHL), and Major League Baseball (MLB) who had a reported ACL tear between 2007 and 2017. The search included these professional sports league databases, public injury databases, and sports news reports. Each player with an identified ACL tear was searched for history of additional ACL injury. Re-tear rate was calculated for each league. For each ACL tear, the laterality, player position, return to play (defined as playing at least one game in a major or minor league in that sport), and approximate time to re-tear (months) were documented. Mechanism of tear (contact vs. non-contact) was recorded when available for the initial tears and retears via news reports or available video. Fisher’s exact test was performed to evaluate differences amongst re-tear rates and ANOVA was used to evaluate differences in time to re-tear amongst the three leagues. RESULTS The total number of ACL tears identified was 109 and the total number of re-tears was 13, for a total re-tear rate of 11.9%. ACL re-tear rates by league did not statistically differ, and were as follows: MLB, 11.5%; NBA, 9.3%; and NHL, 15.0%. Average time to re-tear was also not significantly different and was 24.7 months for MLB, 31.8 months for NBA, and 26.0 months for NHL. Return to play rate after index surgery was 94%, whereas return to play after a revision procedure was 84.6%. Our prior published meta-analysis of pediatric and adolescent ACL reconstruction failure rates was 8.3%. CONCLUSIONS / SIGNIFICANCE The ACL re-tear rates in multiple male professional sports leagues are higher than those reported in large registry studies and similar to the ACL re-injury rates previously reported in the NFL (12.3%). These revision rates are also more similar to those reported for pediatric patients. Exposure to high-risk sporting activity is likely a primary cause of ACL re-tear. The cited rates of ACL re-tear may thus be interpreted as a ‘best-case scenario’ in athletes returning to the highest level of activity, and may help to explain the similar high re-tear rates in the pediatric and adolescent population. TABLES AND FIGURES Figure 1. ACL Re-Injury Rates by League and Age
机译：背景技术接受ACL重建的儿童和青少年患者的再撕裂率高于一般成年人口。据推测，这是由于许多原因造成的。其中之一就是参加高风险活动。职业运动中的运动员再次运动的风险较高，而且运动水平很高，并且经常面临额外的压力，要求他们迅速恢复运动。这项研究的目的是分析ACL重建后运动员在男性职业体育联盟中的ACL退缩率，然后再回到专业水平进行比赛，以确定与儿童和青少年群体是否有相似之处。方法这项描述性流行病学研究包括一项全面的在线搜索，目的是确定美国篮球协会（NBA），美国国家曲棍球联盟（NHL）和美国职业棒球大联盟（MLB）的男运动员，他们在2007年至2017年之间报告了ACL撕裂。包括这些专业体育联赛数据库，公共伤害数据库和体育新闻报道。搜索每名发现ACL撕裂的球员，以寻找其他ACL受伤的历史记录。计算每个联赛的再撕率。对于每次ACL撕裂，都要记录横向性，球员位置，重返比赛状态（定义为在该运动的大联盟或次要联赛中至少打过一场比赛）以及重新上场的大概时间（月）。当可以通过新闻报道或可用的视频进行初始撕裂和撤退时，记录撕裂的机理（接触与非接触）。费舍尔（Fisher）进行了精确测试，以评估重传率之间的差异，而方差分析（ANOVA）被用于评估三个联赛之间的重传时间差异。结果确定的ACL撕裂总数为109，再撕裂的总数为13，总撕裂率为11.9％。联赛的ACL重唱率没有统计学差异，如下：美国职业棒球大联盟，11.5％; NBA，9.3％; NHL为15.0％。平均重撕时间也没有显着差异，MLB为24.7个月，NBA为31.8个月，NHL为26.0个月。索引手术后的重返游戏率为94％，而修订程序后的重返游戏率为84.6％。我们先前发表的儿科和青少年ACL重建失败率的荟萃分析为8.3％。结论/意义在多个男性职业体育联盟中，ACL撕裂率高于大型登记研究中报告的水平，并且与NFL之前报道的ACL损伤率相似（12.3％）。这些修订率也与小儿患者报告的修订率更加相似。暴露于高风险的体育活动可能是ACL撕裂的主要原因。因此，被引用的ACL退缩率可以被解释为回到最高活动水平的运动员的“最佳情况”，并且可以帮助解释小儿和青少年人群中类似的高退缩率。表和图图1.按联赛和年龄划分的ACL再受伤率

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