修订与初次前交叉韧带重建术后重返运动的结果及心理准备度：系统综述与Meta分析
简介
本研究通过系统综述与Meta分析，比较了前交叉韧带（ACL）翻修与初次重建术后患者的重返运动（RTS）结果及心理准备度。共纳入19项研究，涉及3209名运动员。结果显示，与初次重建相比，翻修术后患者重返运动的总体几率略低（OR=0.66），重返伤前竞技水平的几率也较低（OR=0.52），重返运动时间平均延长约1.2个月，且心理准备度评分显著降低约14.2分（…
英文摘要
BACKGROUND: The existing body of evidence referring to the return-to-sport (RTS) outcomes and psychological readiness to return to sport after revision compared to the primary anterior cruciate ligament (ACL) reconstruction has not yet been comprehensively synthesized. OBJECTIVE: To examine RTS outcomes and psychological readiness to return to sport after revision compared to the primary ACL reconstruction. METHODS: A comprehensive search of Web of Science, EMBASE, and PubMed was carried out up to November 15, 2024. Observational studies that compared revision and primary ACL reconstruction regarding RTS outcomes and psychological readiness to return to sport were considered adequate for inclusion. The Methodological Index for Non-Randomized Studies and Grading of Recommendations Assessment, Development, and Evaluation were used to assess methodological quality as well as the overall strength and quality of evidence of involved studies, respectively. RESULTS: A total of 19 studies fulfilled the eligibility criteria and were included in the quantitative analysis. There were 3209 athletes with a history of revision and primary ACL reconstruction (mean age: 26.0 ± 6.5 years; 78% males). The main findings indicated that individuals who were subjected to revision ACL reconstruction had slightly lower odds of RTS (-6%; odds ratio (OR) = 0.66 [95% confidence interval (CI) 0.49 to 0.89]), slightly lower odds of RTS at the preinjury level of competition (-5%; OR = 0.52 [95% CI 0.36 to 0.76]), slightly prolonged RTS time (1.2 months; standardized mean differences (SMD) = 0.38 [95% CI 0.12 to -0.63]), and moderately lower psychological readiness to return to sport (-14.2 points; SMD = -0.75 [95% CI -1.14 to -0.36]) relative to their counterparts who were subjected to the primary ACL surgery. CONCLUSIONS: Athletes who underwent the revision ACL surgery had a 6% reduced rate of RTS, 5% lower rates of RTS at the preinjury level of competition, 1.2 months extended RTS time, and 14.2 points decreased psychological readiness to return to sport relative to the respondents with a history of the primary ACL reconstruction. PROSPERO registration number CRD42024600347.