BACKGROUND Lateral ankle sprains are the most common traumatic musculoskeletal injuries of the lower extremity,with an incidence rate of 15%-20%.The high incidence and prevalence highlights the economic impact of this...BACKGROUND Lateral ankle sprains are the most common traumatic musculoskeletal injuries of the lower extremity,with an incidence rate of 15%-20%.The high incidence and prevalence highlights the economic impact of this injury.Ankle sprains lead to a high socioeconomic burden due to the combination of the high injury incidence and high medical expenses.Up to 40%of patients who suffer from an ankle sprain develop chronic ankle instability.Chronic instability can lead to prolonged periods of pain,immobility and injury recurrence.Identification of factors that influence return to work(RTW)and return to sports(RTS)after a lateral ankle sprain(LAS)may help seriously reduce healthcare costs.AIM To explore which factors may potentially affect RTW and RTS after sustaining an LAS.METHODS EMBASE and PubMed were systematically searched for relevant studies published until June 2023.Inclusion criteria were as follows:(1)Injury including LAS or chronic ankle instability;(2)Described any form of treatment;(3)Assessment of RTW or RTS;(4)Studies published in English;and(5)Study designs including randomized controlled clinical trials,clinical trials or cohort studies.Exclusion criteria were:(1)Studies involving children(age<16 year);or(2)Patients with concomitant ankle injury besides lateral ankle ligament damage.A quality assessment was performed for each of the included studies using established risk of bias tools.Additionally quality of evidence was assessed using the GRADEpro tool in cases where outcomes were included in the quantitative analysis.A best evidence synthesis was performed in cases of qualitative outcome analysis.For all studied outcomes suitable for quantitative analysis a forest plot was created to calculate the effect on RTW and RTS.RESULTS A total of 8904 patients were included in 21 studies,10 randomized controlled trials,7 retrospective cohort studies and 4 prospective cohort studies.Fifteen studies were eligible for meta-analysis.The overall RTS rate ranged were 80%and 83%in the all treatments pool and surgical treatments pool,respectively.The pooled mean days to RTS ranged from 23-93 d.The overall RTW rate was 89%.The pooled mean time to RTW ranged from 5.8-8.1 d.For patients with chronic ankle instability,higher preoperative motivation was the sole factor significantly and independently(P=0.001)associated with the rate of and time to RTS following ligament repair or reconstruction.Higher body mass index was identified as a significant factor(P=0.04)linked to not resuming sports or returning at a lower level(median 24,range 20-37),compared to those who resumed at the same or higher level(median 23,range 17-38).Patients with a history of psychological illness or brain injury,experienced a delay in their rehabilitation process for sprains with fractures and unspecified sprains.The extent of the delayed rehabilitation was directly proportional to the increased likelihood of experiencing a recurrence of the ankle sprain and the number of ankle-related medical visits.We also observed that 10%of athletes who did return to sport after lateral ankle sprain without fractures described non-ankle-related reasons for not returning.CONCLUSION All treatments yielded comparable results,with each treatment potentially offering unique advantages or benefits.Preoperative motivation may influence rehabilitation after LAS.Grading which factor had a greater impact was not possible due to the lack of comparability among the included patients.展开更多
BACKGROUND Between 43%and 75%of patients who undergo primary anterior cruciate ligament(ACL)surgery return to sport activity.However,after a revision ACL reconstruction(ACLR)the rate of return to sports is variable.A ...BACKGROUND Between 43%and 75%of patients who undergo primary anterior cruciate ligament(ACL)surgery return to sport activity.However,after a revision ACL reconstruction(ACLR)the rate of return to sports is variable.A few publications have reported returns to sports incidence between 56%to 100%after revision ACLR.AIM To determine return to sports and functional outcomes after a single-stage revision ACLR with a 5-year minimum follow-up at a single institution.METHODS All patients operated between 2010 and 2016 with a minimum 5 years of followup were included.Type of sport,intensity,frequency,expectation,time to return to sport and failure rate were recorded.Lysholm,Tegner and International Knee Documentation Committee forms were evaluated prior to the first ACLR surgery,at 6 mo after primary surgery and after revision ACLR at 5 years minimum of follow-up.Objective stability was tested with the knee arthrometer test(KT-1000 knee arthrometer,Medmetric Corp).RESULTS A total of 41 patients who underwent revision ACLR during that period of time were contacted and available for follow-up.Median patient age at time of revision was 29 years old[interquartile range(IQR):24.0-36.0],and 39(95.0%)were male.The median time from revision procedure to follow-up was 70 mo(IQR:58.0-81.0).Regarding return to sports,16(39.0%)were at the same level compared to preinjury period,and 25 patients(61.0%)returned at a lower level.Sixty-three percent categorized the sport as very important and 37.0%as important.One patient(2.4%)failed with a recurrent ACL torn.Mean preoperative Lysholm and(SD)16]and 50(SD 11),respectively.At follow-up,mean Lysholm and subjective International Knee Documentation Committee scores were 89(SD 8)and 82(SD 9)(P=0.0001).Mean Tegner score prior to primary ACLR was 6.7(SD 1.3),5.1(1.5 SD)prior to revision ACLR and 5.6(1.6 SD)at follow-up(P=0.0002).Overall,knee arthrometer test measurement showed an average of 6 mm(IQR:4.0-6.0)side-to-side difference of displacement prior to revision ACLR and 3mm(IQR:1.5-4.0)after revision.CONCLUSION Almost 40.0%of patients returned to preinjury sports level and 60.0%to a lower level.These may be useful when counseling a patient regarding sports expectations after a revision ACLR.展开更多
Introduction: Patella tendon rupture (PTR) is a cause of handicap in athletic patients. Surgery remains the actual therapeutic modality with a variety of techniques that permits a return to sport. Our objective was to...Introduction: Patella tendon rupture (PTR) is a cause of handicap in athletic patients. Surgery remains the actual therapeutic modality with a variety of techniques that permits a return to sport. Our objective was to evaluate the return to sporting activities after surgical repair of a PTR. Method: We conducted a retrospective cohort study over five years from January 2016 to April 2021. We included athletes from 18 to 65 years of operating for a PTR. We evaluated: the knee functional score, the level of satisfaction, Lysholm score, VISA-P questionnaire, and return to sports. Results: A total of twenty-one cases of PTR were identified. The median age was 36 years (18 - 63). After surgery, the median follow-up was 17 months (12 - 55). All patients were able to walk at 3 months. A total of 17 patients (85%) returned to sports. The median return to sports was 6 months (5 - 11). Patients who return to a similar sport with a similar initial level of sporting activity were 45% (9 patients). The median time to return to sports for patients at a similar level of sport was 7.5 months (6 - 13). Functional scores were satisfactory;with a VISA-P score of 90/100 (25 - 100) and a Lysholm score of 98/100 (40 - 100). Conclusion: Surgical repair of PTR in athletes offers good results regarding return to sports in terms of proportion and timing whatsoever the technique. The use of protection band wires is reserved for patients with relative satisfaction during suture repair.展开更多
文摘BACKGROUND Lateral ankle sprains are the most common traumatic musculoskeletal injuries of the lower extremity,with an incidence rate of 15%-20%.The high incidence and prevalence highlights the economic impact of this injury.Ankle sprains lead to a high socioeconomic burden due to the combination of the high injury incidence and high medical expenses.Up to 40%of patients who suffer from an ankle sprain develop chronic ankle instability.Chronic instability can lead to prolonged periods of pain,immobility and injury recurrence.Identification of factors that influence return to work(RTW)and return to sports(RTS)after a lateral ankle sprain(LAS)may help seriously reduce healthcare costs.AIM To explore which factors may potentially affect RTW and RTS after sustaining an LAS.METHODS EMBASE and PubMed were systematically searched for relevant studies published until June 2023.Inclusion criteria were as follows:(1)Injury including LAS or chronic ankle instability;(2)Described any form of treatment;(3)Assessment of RTW or RTS;(4)Studies published in English;and(5)Study designs including randomized controlled clinical trials,clinical trials or cohort studies.Exclusion criteria were:(1)Studies involving children(age<16 year);or(2)Patients with concomitant ankle injury besides lateral ankle ligament damage.A quality assessment was performed for each of the included studies using established risk of bias tools.Additionally quality of evidence was assessed using the GRADEpro tool in cases where outcomes were included in the quantitative analysis.A best evidence synthesis was performed in cases of qualitative outcome analysis.For all studied outcomes suitable for quantitative analysis a forest plot was created to calculate the effect on RTW and RTS.RESULTS A total of 8904 patients were included in 21 studies,10 randomized controlled trials,7 retrospective cohort studies and 4 prospective cohort studies.Fifteen studies were eligible for meta-analysis.The overall RTS rate ranged were 80%and 83%in the all treatments pool and surgical treatments pool,respectively.The pooled mean days to RTS ranged from 23-93 d.The overall RTW rate was 89%.The pooled mean time to RTW ranged from 5.8-8.1 d.For patients with chronic ankle instability,higher preoperative motivation was the sole factor significantly and independently(P=0.001)associated with the rate of and time to RTS following ligament repair or reconstruction.Higher body mass index was identified as a significant factor(P=0.04)linked to not resuming sports or returning at a lower level(median 24,range 20-37),compared to those who resumed at the same or higher level(median 23,range 17-38).Patients with a history of psychological illness or brain injury,experienced a delay in their rehabilitation process for sprains with fractures and unspecified sprains.The extent of the delayed rehabilitation was directly proportional to the increased likelihood of experiencing a recurrence of the ankle sprain and the number of ankle-related medical visits.We also observed that 10%of athletes who did return to sport after lateral ankle sprain without fractures described non-ankle-related reasons for not returning.CONCLUSION All treatments yielded comparable results,with each treatment potentially offering unique advantages or benefits.Preoperative motivation may influence rehabilitation after LAS.Grading which factor had a greater impact was not possible due to the lack of comparability among the included patients.
文摘BACKGROUND Between 43%and 75%of patients who undergo primary anterior cruciate ligament(ACL)surgery return to sport activity.However,after a revision ACL reconstruction(ACLR)the rate of return to sports is variable.A few publications have reported returns to sports incidence between 56%to 100%after revision ACLR.AIM To determine return to sports and functional outcomes after a single-stage revision ACLR with a 5-year minimum follow-up at a single institution.METHODS All patients operated between 2010 and 2016 with a minimum 5 years of followup were included.Type of sport,intensity,frequency,expectation,time to return to sport and failure rate were recorded.Lysholm,Tegner and International Knee Documentation Committee forms were evaluated prior to the first ACLR surgery,at 6 mo after primary surgery and after revision ACLR at 5 years minimum of follow-up.Objective stability was tested with the knee arthrometer test(KT-1000 knee arthrometer,Medmetric Corp).RESULTS A total of 41 patients who underwent revision ACLR during that period of time were contacted and available for follow-up.Median patient age at time of revision was 29 years old[interquartile range(IQR):24.0-36.0],and 39(95.0%)were male.The median time from revision procedure to follow-up was 70 mo(IQR:58.0-81.0).Regarding return to sports,16(39.0%)were at the same level compared to preinjury period,and 25 patients(61.0%)returned at a lower level.Sixty-three percent categorized the sport as very important and 37.0%as important.One patient(2.4%)failed with a recurrent ACL torn.Mean preoperative Lysholm and(SD)16]and 50(SD 11),respectively.At follow-up,mean Lysholm and subjective International Knee Documentation Committee scores were 89(SD 8)and 82(SD 9)(P=0.0001).Mean Tegner score prior to primary ACLR was 6.7(SD 1.3),5.1(1.5 SD)prior to revision ACLR and 5.6(1.6 SD)at follow-up(P=0.0002).Overall,knee arthrometer test measurement showed an average of 6 mm(IQR:4.0-6.0)side-to-side difference of displacement prior to revision ACLR and 3mm(IQR:1.5-4.0)after revision.CONCLUSION Almost 40.0%of patients returned to preinjury sports level and 60.0%to a lower level.These may be useful when counseling a patient regarding sports expectations after a revision ACLR.
文摘Introduction: Patella tendon rupture (PTR) is a cause of handicap in athletic patients. Surgery remains the actual therapeutic modality with a variety of techniques that permits a return to sport. Our objective was to evaluate the return to sporting activities after surgical repair of a PTR. Method: We conducted a retrospective cohort study over five years from January 2016 to April 2021. We included athletes from 18 to 65 years of operating for a PTR. We evaluated: the knee functional score, the level of satisfaction, Lysholm score, VISA-P questionnaire, and return to sports. Results: A total of twenty-one cases of PTR were identified. The median age was 36 years (18 - 63). After surgery, the median follow-up was 17 months (12 - 55). All patients were able to walk at 3 months. A total of 17 patients (85%) returned to sports. The median return to sports was 6 months (5 - 11). Patients who return to a similar sport with a similar initial level of sporting activity were 45% (9 patients). The median time to return to sports for patients at a similar level of sport was 7.5 months (6 - 13). Functional scores were satisfactory;with a VISA-P score of 90/100 (25 - 100) and a Lysholm score of 98/100 (40 - 100). Conclusion: Surgical repair of PTR in athletes offers good results regarding return to sports in terms of proportion and timing whatsoever the technique. The use of protection band wires is reserved for patients with relative satisfaction during suture repair.
