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首页> 外文期刊>Orthopaedic Journal of Sports Medicine >Outcomes and Return to Sport After Revision Anterior Cruciate Ligament Reconstruction in Adolescent Athletes
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Outcomes and Return to Sport After Revision Anterior Cruciate Ligament Reconstruction in Adolescent Athletes

机译：经过修改前十字韧带重建青少年运动员后的结果和返回运动

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Background: The number of adolescent anterior cruciate ligament (ACL) injuries is rising with increased participation in higher level athletics at earlier ages. With an increasing number of primary ACL reconstructions (ACLRs) comes a rise in the incidence of revision ACLRs. Purpose: To evaluate the clinical results of revision ACLR across a group of high-level adolescent athletes with at least 2-year follow-up. Study Design: Case series; Level of evidence, 4. Methods: A retrospective review of 21 adolescent athletes (age range, 10-19 years) who underwent revision ACLR with at least 2-year follow-up was conducted. Patient-reported outcome measures (PROMs) included the International Knee Documentation Committee (IKDC) Subjective Knee Evaluation Form, Lysholm knee scoring scale, Tegner activity level scale, and modified Cincinnati Knee Rating System. Return to sport (RTS) and overall patient satisfaction were also assessed. Results: The mean age at the time of surgery was 16.5 years (range, 14-19 years), and the mean follow-up was 46.4 months (range, 24-97 months); 42.9% of patients were female, and 52.4% of patients participated in collision sports. The mean time to failure after primary ACLR was 13.1 ± 8.0 months, and the most common mechanism of failure was noncontact in at least 66.7% of cases. The revision graft type included bone–patellar tendon–bone (BPTB) in 71.4% of cases; 26.7% of BPTB grafts were from the contralateral extremity. Concomitant procedures were performed for intra-articular lesions in 71.4% of patients. The mean patient satisfaction rate was 95.3%. There were 3 cases of a graft reinjury at a mean of 25 months postoperatively. The mean PROM scores were as follows: IKDC, 87.5 ± 12.7; Tegner, 7.2 ± 2.0; Lysholm, 93.7 ± 9.8; and Cincinnati, 93.4 ± 10.0. Of those attempting to RTS, 68.4% of patients successfully returned at the same level of competition. Patients with a lateral compartment chondral injury were less likely to RTS ( P < .05). Independent variables shown to have no significant relationship to PROMs or RTS included age, follow-up, sport classification, associated meniscal tears, revision graft size/type, and concomitant procedures. Conclusion: Revision ACLR can be an effective surgical option in adolescents participating in collision and contact sports, with good to excellent subjective outcome scores. At a minimum 2-year follow-up, a graft rupture after revision ACLR occurred in 14% of cases. Of the athletes attempting to RTS, 68.4% returned to their preinjury level of competition.
机译：背景：青少年前十字架韧带（ACL）伤害的数量随着早期年龄较高的竞技表演而增加。随着越来越多的主要ACL重建（ACLR）的修订ACLRS的发生率升高。目的：评估一组高水平青少年运动员修订ACLR的临床结果，至少有2年的随访。研究设计：案例系列;证据级别，4.方法：对21名青少年运动员（年龄范围，10-19岁）进行了追溯审查，他们进行了至少2年后进行了修订的ACLR。患者报告的结果措施（PROMS）包括国际膝关节文件委员会（IKDC）主观膝关节评估表，Lysholm膝关节评分规模，TEGNER活动水平规模，并改性辛辛那提膝关节级系统。还评估了运动（RTS）和整体患者满意度也得到评估。结果：手术时的平均年龄为16.5岁（范围，14-19岁），平均随访时间为46.4个月（范围，24-97个月）; 42.9％的患者是女性，52.4％的患者参加了碰撞运动。原发性ACLR后的平均故障时间为13.1±8.0个月，最常见的失败机制在至少66.7％的情况下是不可接触的。修正接枝型包括71.4％的骨髌骨肌腱 - 骨（BPTB）; 26.7％的BPTB移植物来自对侧末端。在71.4％的患者中对关节内病变进行伴随程序。平均患者满意度率为95.3％。术后25个月有3例接枝再冻结。平均舞会分数如下：IKDC，87.5±12.7; TEGNER，7.2±2.0; Lysholm，93.7±9.8;和辛辛那提，93.4±10.0。在那些试图RTS的人中，68.4％的患者成功返回在同一级别的竞争水平。患有侧隔室骨损伤的患者不太可能进行RTS（P <.05）。独立变量显示与PROMS或RTS没有显着的关系包括年龄，随访，体育分类，相关的半月板眼泪，修改移植尺寸/类型和伴随程序。结论：修订ACLR可以是参与碰撞和联系运动的青少年的有效手术选择，善于良好的主观结果分数。在5年后，在修订ACLR后发生接枝破裂，在14％的情况下发生。在试图RTS的运动员中，68.4％回到了他们的竞争水平。

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