Return to Sport in Patients Undergoing Primary, Revision, and Re-revision Anterior Cruciate Ligament Surgery: A Comparative Cohort Study with a Minimum Six-Year Follow-Up
DOI:
https://doi.org/10.63403/re.v32i2.403Keywords:
Return to Sport, Revision ACL, Re-revision ACL, Sports ParticipationAbstract
Introduction: return to sport after anterior cruciate ligament (ACL) reconstruction is a multifactorial process.
Objectives: retrospectively compare sports performance outcomes in a consecutive series of patients undergoing primary ACL surgery, ACL revision (ACLR), and ACL re-revision (R-ACLR) with a minimum follow-up of six years.
Materials and methods: a total of 135 patients were evaluated and divided into three groups. Data collected included type of sport, impact level, frequency, motivation, expectations, time to return to sport, failures, Lysholm, IKDC, and Tegner scales.
Results: Group A (primary reconstruction) consisted of eighty-two patients with a median age of twenty years (IQR: 25-45) and a follow-up of 136 months (IQR: 106-150). The average time to return to sports was eleven months (SD: 1.4). A total of 53% returned to a higher level, 37% to lower levels, and 7% did not return. The Tegner score remained stable at 7 (IQR: 5-7).
In Group B (revisions), which included forty-one patients, the median age at the time of revision was twenty-nine years (IQR: 24-36) with a follow-up of seventy-three months (IQR: 58-81). The average return time was 12.5 months. A total of 73% returned to the same level, 21% to lower levels, and 6% did not return. The Tegner score decreased from 7 (IQR: 7-7) to 4 (IQR: 4-7).
In Group C (re-revisions), with twelve patients, the median age was thirty-two years (IQR: 30–34) and follow-up was sixty-one months (IQR: 28-108). The average return time was twelve months. A total of 42% did not return, 42% returned to a lower level, and 16% to the same level. The Tegner score decreased from 7 (IQR: 7-7) to 5 (IQR: 4-7). Regardless of age, the number of surgeries is a factor associated with not returning to sports [OR: 0.2 (95% CI: 0.05-0.85; p <0.03)].
Conclusion: repeated ACL reconstruction surgeries are associated with a reduction in participation in highimpact sports and an increase in participation in moderate-impact activities, regardless of the age at the time of surgery.
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