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Effect of a Concussion on Anterior Cruciate Ligament Injury Risk in a General Population.
Sports Medicine ( IF 9.3 ) Pub Date : 2020-06-01 , DOI: 10.1007/s40279-020-01262-3
April L McPherson 1, 2 , Matthew B Shirley 2 , Nathan D Schilaty 2, 3, 4 , Dirk R Larson 5 , Timothy E Hewett 6
Affiliation  

BACKGROUND Recent studies indicate concussion increases risk of musculoskeletal injury in specific groups of patients. The purpose of this study was to determine the odds of anterior cruciate ligament (ACL) injury after concussion in a population-based cohort. METHODS International Classification of Diseases, 9th and 10th Revision (ICD-9, ICD-10) codes relevant to the diagnosis and treatment of a concussion and ACL tear were utilized to search the Rochester Epidemiology Project (REP) between 2000 and 2017. A total of 1653 unique patients with acute, isolated ACL tears were identified. Medical records for cases were reviewed to confirm ACL tear diagnosis and to determine history of concussion within 3 years prior to the ACL injury. Cases were matched by age, sex, and REP availability date to patients without an ACL tear (1:3 match), resulting in 4959 controls. The medical records of the matched control patients were reviewed to determine history of concussion. RESULTS 39 patients with a concussion suffered an ACL injury up to 3 years after the concussion. The rate of prior concussion was higher in ACL-injured cases (2.4%) compared to matched controls with no ACL injury (1.5%). This corresponds to an odds ratio of 1.6 (95% CI 1.1-2.4; p = 0.015). CONCLUSIONS Although activity level could not be assessed, there are increased odds of ACL injury after concussion in a general population. Based on the evidence of increased odds of musculoskeletal injury after concussion, standard clinical assessments should consider concussion symptom resolution as well as assessment of neuromuscular factors associated with risk of injuries.

中文翻译:

脑震荡对一般人群前十字韧带损伤风险的影响。

背景技术最近的研究表明脑震荡增加了特定患者组的肌肉骨骼损伤的风险。这项研究的目的是确定在以人群为基础的队列中脑震荡后前交叉韧带(ACL)损伤的几率。方法利用2000年至2017年间的国际疾病分类第9和第10修订版(ICD-9,ICD-10)与脑震荡和ACL撕裂的诊断和治疗相关的代码来搜索罗切斯特流行病学项目(REP)。确定了1653例急性,孤立ACL眼泪的独特患者。检查病例的医疗记录,以确认ACL撕裂的诊断并确定ACL损伤前3年内的脑震荡史。对于没有ACL撕裂的患者,按年龄,性别和REP有效期进行匹配(1:3匹配),产生了4959个控件。回顾了匹配的对照患者的病历,以确定脑震荡史。结果39例脑震荡患者在脑震荡后3年内遭受了ACL损伤。与没有ACL损伤的配对对照组(1.5%)相比,ACL损伤病例的先前脑震荡发生率更高(2.4%)。这对应于1.6的优势比(95%CI 1.1-2.4; p = 0.015)。结论尽管无法评估活动水平,但普通人群脑震荡后ACL损伤的可能性增加。根据脑震荡后肌肉骨骼损伤几率增加的证据,标准临床评估应考虑脑震荡症状的缓解以及与受伤风险相关的神经肌肉因素的评估。回顾了匹配的对照患者的病历,以确定脑震荡史。结果39例脑震荡患者在脑震荡后3年内遭受了ACL损伤。与没有ACL损伤的配对对照组(1.5%)相比,ACL损伤病例的先前脑震荡发生率更高(2.4%)。这对应于1.6的优势比(95%CI 1.1-2.4; p = 0.015)。结论尽管无法评估活动水平,但普通人群脑震荡后ACL损伤的可能性增加。根据脑震荡后肌肉骨骼损伤几率增加的证据,标准临床评估应考虑脑震荡症状的缓解以及与受伤风险相关的神经肌肉因素的评估。回顾了匹配的对照患者的病历,以确定脑震荡史。结果39例脑震荡患者在脑震荡后3年内遭受了ACL损伤。与没有ACL损伤的配对对照组(1.5%)相比,ACL损伤病例的先前脑震荡发生率更高(2.4%)。这对应于1.6的优势比(95%CI 1.1-2.4; p = 0.015)。结论尽管无法评估活动水平,但普通人群脑震荡后ACL损伤的可能性增加。根据脑震荡后肌肉骨骼损伤几率增加的证据,标准临床评估应考虑脑震荡症状的缓解以及与受伤风险相关的神经肌肉因素的评估。结果39例脑震荡患者在脑震荡后3年内遭受了ACL损伤。与没有ACL损伤的配对对照组(1.5%)相比,ACL损伤病例的先前脑震荡发生率更高(2.4%)。这对应于1.6的优势比(95%CI 1.1-2.4; p = 0.015)。结论尽管无法评估活动水平,但普通人群脑震荡后ACL损伤的可能性增加。根据脑震荡后肌肉骨骼损伤几率增加的证据,标准临床评估应考虑脑震荡症状的缓解以及与受伤风险相关的神经肌肉因素的评估。结果39例脑震荡患者在脑震荡后3年内遭受了ACL损伤。与没有ACL损伤的配对对照组(1.5%)相比,ACL损伤病例的先前脑震荡发生率更高(2.4%)。这对应于1.6的优势比(95%CI 1.1-2.4; p = 0.015)。结论尽管无法评估活动水平,但普通人群脑震荡后ACL损伤的可能性增加。根据脑震荡后肌肉骨骼损伤几率增加的证据,标准临床评估应考虑脑震荡症状的缓解以及与受伤风险相关的神经肌肉因素的评估。与没有ACL损伤的配对对照组(1.5%)相比,只有4%)。这对应于1.6的优势比(95%CI 1.1-2.4; p = 0.015)。结论尽管无法评估活动水平,但普通人群脑震荡后ACL损伤的可能性增加。根据脑震荡后肌肉骨骼损伤发生几率增加的证据,标准临床评估应考虑脑震荡症状的缓解以及与受伤风险相关的神经肌肉因素的评估。与没有ACL损伤的配对对照组(1.5%)相比,只有4%)。这对应于1.6的优势比(95%CI 1.1-2.4; p = 0.015)。结论尽管无法评估活动水平,但普通人群脑震荡后ACL损伤的可能性增加。根据脑震荡后肌肉骨骼损伤几率增加的证据,标准临床评估应考虑脑震荡症状的缓解以及与受伤风险相关的神经肌肉因素的评估。
更新日期:2020-01-22
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