חזרה לספורט תחרותי לאחר שחזור צולבת קדמית ACL בברך

תאריך: 09/05/2016
מפרסם: Br J Sports Med

במחקר פרוספקטיבי נמצא כי:

  1. חזרה לספורט תחרותי הגבירה פי 4 סיכוי לקרע חוזר של הרצועה בשנתיים ראשונות
  2. חזרה לפעילות לפני 9 חודשים היתה כרוכה בסיכון מוגבר לקרע חוזר
  3. נקבעו קריטריונים למבחן של חזרה לפעילות ספורטיבית (שאלונים, מבחן קפיצה, כוח  ארבע ראשי)
  4. אלו שעמדו בתוצאות של 80% מכל מבחני הקריטריונים  היו בסיכון קטן משמעותית 5.6% לקרע חוזר לעומת אלו שנכשלו באחד מהמבחנים ( 38.2%סיכוי לקרע חוזר)

יפתח בר

Br J Sports Med. 2016 May 9. pii: bjsports-2016-096031. doi: 10.1136/bjsports-2016-096031. [Epub ahead of print]

Simple decision rules can reduce reinjury risk by 84% after ACL reconstruction: the Delaware-Oslo ACL cohort study.

Abstract

BACKGROUND:

Knee reinjury after ACL reconstruction is common and increases the risk of osteoarthritis. There is sparse evidence to guide return to sport (RTS) decisions in this population.

OBJECTIVES:

To assess the relationship between knee reinjury after ACL reconstruction and (1) return to level I sports, (2) timing of RTS and (3) knee function prior to return.

METHODS:

106 patients who participated in pivoting sports participated in this prospective 2-year cohort study. Sports participation and knee reinjury were recorded monthly. Knee function was assessed with the Knee Outcome Survey-Activities of Daily Living Scale, global rating scale of function, and quadriceps strength and hop test symmetry. Pass RTS criteria were defined as scores >90 on all tests, failure as failing any.

RESULTS:

Patients who returned to level I sports had a 4.32 (p=0.048) times higher reinjury rate than those who did not. The reinjury rate was significantly reduced by 51% for each month RTS was delayed until 9 months after surgery, after which no further risk reduction was observed. 38.2% of those who failed RTS criteria suffered reinjuries versus 5.6% of those who passed (HR 0.16, p=0.075). More symmetrical quadriceps strength prior to return significantly reduced the knee reinjury rate.

CONCLUSIONS:

Returning to level I sports after ACL reconstruction leads to a more than 4-fold increase in reinjury rates over 2 years. RTS 9 months or later after surgery and more symmetrical quadriceps strength prior to return substantially reduce the reinjury rate.

כתיבת תגובה