Rates and Levels of Elite Sport Participation at 5 Years After Revision ACL Reconstruction.

Autor:	Pinheiro VH; Fortius Clinic, London UK, FIFA Medical Centre of Excellence, London, UK., Jones M; Fortius Clinic, London UK, FIFA Medical Centre of Excellence, London, UK., Borque KA; Houston Methodist Orthopedics and Sports Medicine, Houston, Texas, USA., Balendra G; Fortius Clinic, London UK, FIFA Medical Centre of Excellence, London, UK., White NP; Park Clinic Orthopaedics, Melbourne Knee Centre, Melbourne, Australia., Ball SV; Fortius Clinic, London UK, FIFA Medical Centre of Excellence, London, UK.; Chelsea and Westminster Hospital NHS Foundation Trust, London, UK., Williams A; Fortius Clinic, London UK, FIFA Medical Centre of Excellence, London, UK.
Jazyk:	angličtina
Zdroj:	The American journal of sports medicine [Am J Sports Med] 2022 Dec; Vol. 50 (14), pp. 3762-3769. Date of Electronic Publication: 2022 Nov 03.
DOI:	10.1177/03635465221127297
Abstrakt:	Background: There is a paucity of data regarding return to play (RTP), level of competition, and longevity of play after revision of anterior cruciate ligament (ACL) reconstruction (ACLR) in elite athletes. Purpose: To report RTP rates and competition levels in elite athletes at the point of RTP, as well as at 2 and 5 years after revision ACLR, and the effect of meniscal and chondral pathology at revision surgery on these outcomes. Study Design: Case series; Level of evidence, 4. Methods: A retrospective review of a consecutive series of all revision ACLRs undertaken by the senior author between 2009 and 2019, with a minimum 2-year follow-up, was carried out. Outcome measures were RTP rates and competition level. Results: A total of 49 knees in 48 elite athletes met the inclusion criteria. After revision ACLR, 43 (87.8%) elite athletes achieved RTP, of whom 75.5% were at the same level. At 2 years after surgery, 39 (79.6%) were still playing, 25 (51%) at the same level; at 5 years after surgery, 20 (44.4%) were still playing, 9 (20%) at the same level. Elite athletes with <50% thickness or no articular cartilage lesions were more likely to RTP (94.6% vs 66.7%; P = .026), as well as return to the same competition level (83.8% vs 50%; P = .047), compared with those with ≥50% thickness chondral lesions. Those without medial meniscal pathology were more likely to RTP at the same level after revision surgery (94.4% vs 64.5%; P = .036). The median time elite athletes continued to play after revision ACLR was 73 months (95% CI, 43.4-102.6); 23 months at the same level (95% CI, 13.6-32.4). The probability of still playing at 5 years after surgery was 55.9%, with a 22.5% chance of maintaining preinjury competition level. Conclusion: In elite athletes, RTP rates and competition level decreased over time after revision ACLR. The presence of >50% thickness chondral pathology was associated with lower RTP rates and competition level at RTP time, while medial meniscal pathology was associated with lower competition level at RTP.
Databáze:	MEDLINE
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