场内外康复对足球运动员前交叉韧带重建术后重返赛场及再损伤风险的影响：一项401例连续病例研究
简介
本研究回顾性分析了401例接受ACL重建的男性足球运动员，旨在探讨术前、术中、术后变量（包括场地康复参与情况）与重返运动及再损伤风险的关系。所有患者均完成包含场地康复阶段的标准化康复方案。 结果显示，中位随访40.6个月后，84%的运动员重返伤前竞技水平，职业与业余运动员重返时间分别为5.9±2.1和6.9±3.2个月。更高的场地康复总时长和每周频率与更高的…
英文摘要
PURPOSE: Examine the association between preoperative, intraoperative and postoperative variables, including on-field rehabilitation (OFR) participation and return to play (RTP) rates and re-injury risk in a large cohort of 11-a-side football (soccer) players after anterior cruciate ligament reconstruction (ACLR). METHODS: Data from 401 male football players who underwent primary ACLR were retrospectively analysed. All players completed a standardised rehabilitation protocol, involving a period of OFR. Participants were stratified by competitive level (professionals and amateurs), and between-group differences in RTP and re-injury outcomes were documented. The association between preoperative, intraoperative and postoperative variables for each outcome was assessed using logistic regressions, controlling for competitive level. RESULTS: Median follow-up time was 40.6 months post-ACLR. Eighty-four percent of players RTP at their pre-injury competitive level, with professionals (88%) and amateurs (83%) returning in 5.9 ± 2.1 and 6.9 ± 3.2 months, respectively. Greater OFR volume (odds ratio [OR], 1.06; 95% confidence interval [CI], 1.00-1.12; p = 0.034) and weekly frequency (OR, 1.53; 95% CI, 1.00-1.07; p = 0.014) were associated with increased RTP likelihood. High OFR compliance was associated with higher odds of RTP (OR = 2.62, p = 0.003), in which 91% of compliant players RTP at their pre-injury competitive level. Forty-two players (10%) sustained a second ACL injury (20 ipsilateral and 22 contralateral). OFR variables were not significantly associated with overall second ACL re-injury risk. In an exploratory subgroup analysis of young (<20 years old) players, OFR compliance was associated with lower odds of ipsilateral re-injury (OR = 0.23, p = 0.041). CONCLUSION: ACLR football players in our cohort had high RTP (88%) and low ACL re-injury risk (10%). Greater exposure to OFR, particularly higher volume and weekly frequency, was associated with an increased likelihood of RTP. No association was observed between OFR compliance and overall second ACL injury risk, although in young players, greater OFR compliance was associated with a reduction in ipsilateral ACL re-injury. LEVEL OF EVIDENCE: Level IV.