Functional outcome in patients following cartilage regeneration outcome at minimum follow-up of 12 months

摘要

Introduction: Several studies have focused on the return to play rate after ACL reconstruction. Whereas most studies just report the rate as a result, only few studies evaluate specific parameters and tests to further investigate the conditions of when the patients should return to sports. Hypotheses: Aim of this study was to compare the return to competition rate of patients 12 months after ACL reconstruction and correlate the rate and re-rupture fate to the assessed multifactorial “return-to-sports” test 3 months after ACL reconstruction at our institution. Methods: A total of 51 Patients undergoing ACL reconstruction are prospectively evaluated using a “return-to-sports” test 3 months following ACL reconstruction. Inclusion criteria was isolated ACL rupture, Level 1 sports participation, free range of motion at FU 3 months, age &18 and &50, no associated ligamentous or meniscal injury influencing the rehab protocol and intact contralateral leg. ACL reconstructions were performed by a single surgeon with semitendinosus graft and standardized rehabilitation protocol. Follow-up at 3 months postoperatively was performed using a functional analysis including isokinetic strength measurements (BTE-primus), proprioceptive tests (MTF tests) and a 3d-motion analysis (myomotion, Noraxon) during bilateral drop jumps and single leg hop tests. To evaluate the return to play rate and recurrent instability problems a survey was used at timepoint 12 months postoperatively (n=43 at abstract submission). Results: At timepoint 12 months following ACL reconstruction 6 of 43 currently evaluated patients did not return to competition (6/43). A total of 5 patients were evaluated as moderate to high risk for ACL recurrent instability in the return-to-sports analysis at three months whereas one patient not returning to competition showed a not elevated risk for ACL recurrent instability in the analysis. The was a high correlation of patients revealing better functional results in the functional analysis (isokinetic strength, proprioceptive test and a 3d-motion analysis) and returning to sports. A total of 8 patients (4/43) suffered a recurrent instability after returning to sports. Conclusion: This prospective analysis of patients following semitendinosus ACL reconstruction with one single surgeon implicates that the rate of returning to sports in patients using a multifactorial “return-to-sports” analysis at 3 months postoperatively is higher compared to the rate of patients without such an analysis in the literature. We found a high correlation between better functional results and return to play rate as well as a re-rupture rate of 10% in patients after returning to sports.