Delayed Anterior Cruciate Ligament Reconstruction Is Associated With Lower Odds of Returning to Preinjury Physical Activity Level at 12 Months Follow-Up.

IF 4.4 1区 医学 Q1 ORTHOPEDICS
Johan Högberg, Emily Fridh, Ramana Piussi, Rebecca Hamrin Senorski, Riccardo Cristiani, Kristian Samuelsson, Roland Thomeé, Eric Hamrin Senorski
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引用次数: 0

Abstract

Purpose: To examine the effects of timing of anterior cruciate ligament (ACL) reconstruction on the odds to recover muscle (quadriceps and hamstring) strength, return to preinjury physical activity level, and achieve rehabilitation goals at 12 months follow-up.

Methods: Data were extracted from a local rehabilitation registry in Sweden in November 2023. Patients ≥16 years old who underwent primary ACL reconstruction with hamstring tendon autografts, who underwent isokinetic muscle strength assessment, and responded to patient-reported outcomes 12 months after surgery were included. A multivariable logistic regression analysis was used to analyze the association between timing of ACL reconstruction and the recovery of muscle strength, return to preinjury physical activity level, and achievement of rehabilitation goals. The results of the logistic regression analysis were expressed as odds ratios for every 1-unit increase in the predictor variable (months between ACL injury and reconstruction).

Results: In total, 715 patients were included, of whom 53.4% (n = 383) were women. The mean age at ACL reconstruction was 28.3 ± 10.5 years, and the median time between ACL injury to reconstruction was 4.9 months (interquartile range [IQR] 2.9-9.4). Delayed ACL reconstruction significantly decreased the odds of returning to preinjury physical activity level at 12 months in patients with a Tegner score of 6-10 (odds ratio 0.97; 95% confidence interval 0.94-0.99, P = .009), regardless of age. Shorter median time in months from ACL injury to reconstruction was observed for patients who returned to preinjury physical activity level, especially in younger patients (16-30 years old) (3.9 [IQR 2.5, 6.5] vs 4.7 [IQR 2.9, 9.1], P = .007) and in patients who participated in pivoting activities (Tegner scale 6-10) preinjury (3.4 [IQR 2.3, 6.2] vs 5.0 [IQR 2.9, 9.7], P < .001).

Conclusions: Delayed ACL reconstruction reduces the odds of returning to preinjury physical activity level in patients active in pivoting activities preinjury (Tegner 6-10), regardless of age, 12 months after surgery.

Level of evidence: Level III, retrospective study.

在12个月的随访中,延迟前交叉韧带重建与恢复到损伤前体力活动水平的几率较低相关。
目的:探讨前交叉韧带(ACL)重建时机对肌肉(股四头肌和腘绳肌)力量恢复几率的影响,恢复到损伤前的体力活动水平,并在12个月的随访中实现康复目标。方法:数据提取自2023年11月瑞典当地康复登记处。患者年龄≥16岁,采用腘绳肌腱自体移植物进行初级前交叉韧带重建,进行等速肌力评估,并在术后12个月对患者报告的结果有反应。采用多变量logistic回归分析,分析前交叉韧带重建时间与肌肉力量恢复、恢复损伤前体力活动水平和康复目标实现之间的关系。逻辑回归分析的结果表示为预测变量(ACL损伤与重建之间的月数)每增加1个单位的优势比(OR)。结果:共纳入715例患者,其中女性53.4% (n=383)。ACL重建的平均年龄为28.3±10.5岁,ACL损伤至重建的中位时间为4.9个月(IQR为2.9;9.4)。延迟前交叉韧带重建显著降低Tegner评分为6-10的患者在12个月时恢复到损伤前体力活动水平的几率(OR 0.97 [95% CI 0.94;0.99], p=0.009),与年龄无关。从ACL损伤到重建的中位月时间较短,恢复到损伤前体力活动水平的患者,尤其是年轻患者(16-30岁)(3.9 [IQR 2.5;6.5]对4.7 [IQR 2.9;9.1], p=0.007)和参加损伤前旋转活动(Tegner量表6-10)的患者(3.4 [IQR 2.3-6.2]对5.0 [IQR 2.9-9.7], p。延迟前交叉韧带重建降低了损伤前运动活跃的患者恢复到损伤前身体活动水平的几率(Tegner 6-10),以及手术后12个月的患者,无论年龄大小。证据水平:III。回顾性研究。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
9.30
自引率
17.00%
发文量
555
审稿时长
58 days
期刊介绍: Nowhere is minimally invasive surgery explained better than in Arthroscopy, the leading peer-reviewed journal in the field. Every issue enables you to put into perspective the usefulness of the various emerging arthroscopic techniques. The advantages and disadvantages of these methods -- along with their applications in various situations -- are discussed in relation to their efficiency, efficacy and cost benefit. As a special incentive, paid subscribers also receive access to the journal expanded website.
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