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CC BY-NC-ND 4.0 · Revista Chilena de Ortopedia y Traumatología 2020; 61(01): 002-010
DOI: 10.1055/s-0040-1709721
Original Article | Artículo Original
Thieme Revinter Publicações Ltda Rio de Janeiro, Brazil

Retorno Deportivo Luego de Reconstrucción Primaria de Ligamento Cruzado Anterior con Injerto Hueso-Tendón Patelar-Hueso Autólogo: Análisis de Factores Relacionados

Return to Play after Anterior Cruciate Ligament Reconstruction with Bone-Patellar Tendon-Bone Autograft: Analysis of Related Factors
A. Pakuts
1   Especialista en Traumatología y Ortopedia, Facultad de Medicina, Pontificia Universidad Católica de Chile, Chile
2   Centro Médico Ossis, La Serena, Chile
,
L. Martin 
3   Interno, Facultad de Medicina, Pontificia Universidad Católica de Chile, Chile
,
J. Contador 
3   Interno, Facultad de Medicina, Pontificia Universidad Católica de Chile, Chile
› Institutsangaben
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Publikationsverlauf

07. August 2019

10. März 2020

Publikationsdatum:
24. April 2020 (online)

   Lizenzen und Reprints

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.

Resumen

Objetivos Analizar el retorno deportivo y factores asociados tras la reconstrucción primaria de ligamento cruzado anterior (LCA).

Métodos Estudio observacional descriptivo. Se incluyeron 173 operados entre 2014 y 2017 por el mismo cirujano, los cuales contestaron un cuestionario al menos 12 meses después de la cirugía. El cuestionario incluye IKDC subjetivo, Tegner activity level (pre y post operatorio) y preguntas de elaboración propia.

Resultados La edad promedio es 30,8 años, el 85% son hombres, el 73% practicaba fútbol y la mediana del IKDC fue 71. La media de meses hasta responder el cuestionario fue de 28 meses. Tegner pre-lesión promedio fue de 5 vs 4,3 postoperatorio, p < 0,001. Según la escala Tegner el 57% retorna al mismo nivel previo, sin embargo, de acuerdo con el cuestionario propio solo el 24% lo haría. De ese subgrupo, el 51% tiene temor a lesionarse de nuevo y el 26% reporta razones no relacionadas a la rodilla. No encontramos asociación entre lesiones meniscales y la tasa de retorno. Aquellos que retornan tienen menor prevalencia de lesiones condrales (35% vs 60%, p = 0,002). Los pacientes que retornaron tuvieron un IKDC superior (73,5 vs 64,3, p < 0,001). El sexo masculino tiene una tasa de retorno de 70% vs 48% de su contraparte femenina (p = 0,037).

Conclusiones El 67% retorna al deporte y el 57% lo hace al mismo nivel. Factores positivos relacionados al retorno fueron sexo masculino, ausencia de lesión condral y mejor resultado funcional. Factores psicológicos con el miedo a lesionarse de nuevo son frecuentes en pacientes que no recuperan el nivel previo.

Keywords

anterior cruciate ligament - reconstruction - return to sports - kinesiophobia - bone patellar tendon bone

Palabras Clave

ligamento cruzado anterior - reconstrucción - retorno deportivo - temor a nueva lesión - hueso tendón hueso patelar
 

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