Higher Rate of Return to Preinjury Activity Levels After Anterior Cruciate Ligament Reconstruction With a Bone–Patellar Tendon–Bone Versus Hamstring Tendon Autograft in High-Activity Patients: Results From the New Zealand ACL Registry
| Autor: | Hamish Love, Andrew Paul Monk, Mark Clatworthy, Simon W. Young, Richard Rahardja |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Male
medicine.medical_specialty Anterior cruciate ligament reconstruction Sports medicine medicine.medical_treatment Anterior cruciate ligament Physical Therapy Sports Therapy and Rehabilitation Transplantation Autologous Return to sport Cohort Studies Bone patellar tendon bone Patellar Ligament medicine Humans High activity Orthopedics and Sports Medicine Registries Autografts Anterior Cruciate Ligament Reconstruction business.industry Anterior Cruciate Ligament Injuries Hamstring Tendons Return to activity musculoskeletal system Surgery surgical procedures operative medicine.anatomical_structure Hamstring tendon business New Zealand |
| Zdroj: | The American Journal of Sports Medicine. 49:3488-3494 |
| ISSN: | 1552-3365 0363-5465 |
| DOI: | 10.1177/03635465211044142 |
| Popis: | Background: In primary anterior cruciate ligament (ACL) reconstruction, a bone–patellar tendon–bone (BTB) autograft is associated with lower ipsilateral failure rates. BTB autografts are associated with a higher rate of contralateral ACL injuries, which some clinicians view as a marker of success of the BTB autograft. However, there is a lack of evidence on whether BTB autografts improve the rate of return to activity and sport. Purpose: To compare the rate of return to preinjury activity levels in high-activity patients after ACL reconstruction with BTB autograft or hamstring tendon autograft. Study Design: Cohort study; Level of evidence, 3. Methods: In a high-activity cohort of patients recorded between 2014 and 2018 in the New Zealand ACL Registry, prospectively collected data on preinjury and postoperative Marx activity scores were analyzed. The proportion of patients who returned to their preinjury activity levels at 1- and 2-year follow-up was compared between graft types. Results: Overall, 11.3% (208/1844) of patients returned to their preinjury activity levels at 1-year follow-up, and 15.5% (184/1190) returned at 2-year follow-up. At 1-year follow-up, 17.2% of patients with a BTB autograft returned to their preinjury activity levels compared with 9.3% of patients with a hamstring tendon autograft (adjusted odds ratio, 1.59 [95% CI, 1.16-2.17]; P = .004). At 2-year follow-up, 23.3% of patients with a BTB autograft had returned to their preinjury activity levels compared with 13.3% of patients with a hamstring tendon autograft (adjusted odds ratio, 1.63 [95% CI, 1.14-2.34]; P = .008). Male sex and younger age were associated with a higher rate of return to activity at both follow-up time points. Conclusion: The use of BTB autografts increased the odds of returning to preinjury activity levels at early follow-up. A higher rate of return to activity is a possible explanation for the higher rate of contralateral ACL injuries with the use of BTB autografts. |
| Databáze: | OpenAIRE |
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