Retorno Deportivo Luego de Reconstrucción Primaria de Ligamento Cruzado Anterior con Injerto Hueso-Tendón Patelar-Hueso Autólogo: Análisis de Factores Relacionados
{"title":"Retorno Deportivo Luego de Reconstrucción Primaria de Ligamento Cruzado Anterior con Injerto Hueso-Tendón Patelar-Hueso Autólogo: Análisis de Factores Relacionados","authors":"A. Pakuts, L. Martin, J. Contador","doi":"10.1055/s-0040-1709721","DOIUrl":null,"url":null,"abstract":"Abstract Objective Analyze return to sports and related factors after primary anterior cruciate ligament reconstruction. Methods Observational descriptive study. 173 patients operated by the same surgeon and standardized technique (patellar autograft) who answered a questionnaire at least 12 months post procedure were included. Questionnaire included Subjective IKDC, Tegner activity level (Pre and Postoperative) and questions elaborated by the group. Results Mean age was 30.8 years, 85% were men, 73% practiced soccer and median postoperative IKDC was 71. Follow up until questionnaire response was 28 months. Males had a better return to sports than females (70% vs 48%, p = 0.037). Tegner pre-injury level was 5 vs 4.3 postoperative, (p < 0.001). Return to sports was 67% according to Tegner scale and 66% by self-assessment. Return to similar previous activity level was 57% by Tegner scale but 24% by direct questions. Of those patients, 51% have fear of re-injury and 26% by reasons other than knee or surgery. We didn't find association between meniscal injuries and return to sports rate. Patients with chondral injuries had lower rates in return to sports (35% vs 60%, p = 0.002). Subjects that returned to sports had higher IKDC scores (73.5 vs 64.3, p < 0.001). Conclusions We found 67% return to sports and 57% to the preinjury level. Positive return to sports factors were male sex, absence of chondral injury and better functional outcome. Psychological factors such as fear of injury is frequent in patients who don't achieve previous levels of activity.","PeriodicalId":21194,"journal":{"name":"Revista Chilena de Ortopedia y Traumatología","volume":"10 1","pages":"002 - 010"},"PeriodicalIF":0.0000,"publicationDate":"2020-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Revista Chilena de Ortopedia y Traumatología","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1055/s-0040-1709721","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
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Abstract
Abstract Objective Analyze return to sports and related factors after primary anterior cruciate ligament reconstruction. Methods Observational descriptive study. 173 patients operated by the same surgeon and standardized technique (patellar autograft) who answered a questionnaire at least 12 months post procedure were included. Questionnaire included Subjective IKDC, Tegner activity level (Pre and Postoperative) and questions elaborated by the group. Results Mean age was 30.8 years, 85% were men, 73% practiced soccer and median postoperative IKDC was 71. Follow up until questionnaire response was 28 months. Males had a better return to sports than females (70% vs 48%, p = 0.037). Tegner pre-injury level was 5 vs 4.3 postoperative, (p < 0.001). Return to sports was 67% according to Tegner scale and 66% by self-assessment. Return to similar previous activity level was 57% by Tegner scale but 24% by direct questions. Of those patients, 51% have fear of re-injury and 26% by reasons other than knee or surgery. We didn't find association between meniscal injuries and return to sports rate. Patients with chondral injuries had lower rates in return to sports (35% vs 60%, p = 0.002). Subjects that returned to sports had higher IKDC scores (73.5 vs 64.3, p < 0.001). Conclusions We found 67% return to sports and 57% to the preinjury level. Positive return to sports factors were male sex, absence of chondral injury and better functional outcome. Psychological factors such as fear of injury is frequent in patients who don't achieve previous levels of activity.
摘要目的分析原发性前交叉韧带重建术后恢复运动能力及相关因素。方法观察性描述性研究。173名接受同一外科医生和标准化技术(自体髌骨移植)手术的患者在手术后至少12个月接受问卷调查。问卷包括主观IKDC、Tegner活动水平(术前和术后)及组内自行制定的问题。结果平均年龄30.8岁,85%为男性,73%为足球运动员,术后中位IKDC为71。随访至问卷回复28个月。男性比女性有更好的运动回报(70%比48%,p = 0.037)。Tegner损伤前水平为5,术后水平为4.3,(p < 0.001)。根据Tegner量表,运动回归率为67%,自我评估为66%。Tegner量表的回复率为57%,而直接问题的回复率为24%。在这些患者中,51%的人害怕再次受伤,26%的人是因为膝盖或手术以外的原因。我们没有发现半月板损伤和恢复运动率之间的联系。软骨损伤患者恢复运动的比例较低(35% vs 60%, p = 0.002)。重返运动的受试者IKDC得分更高(73.5 vs 64.3, p < 0.001)。结论:67%的患者恢复运动,57%的患者恢复到损伤前水平。积极恢复运动的因素为男性、无软骨损伤和较好的功能预后。心理因素,如害怕受伤,在没有达到以前运动水平的患者中很常见。