Purpose

To analyse the effects of graft selection, sex, injury complexity and time to return to competition on the odds to suffer secondary ACL injury (either re-rupture or contralateral ACL tear) in professional alpine skiers.

Methods

The database of a specialised joint surgery clinic was screened for professional alpine skiers who had participated in competitions at the FIS race, European Cup and World Cup level prior to having to undergo a primary ACL reconstruction, and who had returned to the same competitional level at least one year prior to the end of the observation period. The rates of secondary ACL injuries were statistically compared between athletes with hamstring and quadriceps tendon autografts, men and women, simple and complex (involvement of menisci or cartilage) primary ACL injuries, and between early (≤ 300 days after primary reconstruction) and late (> 300 days) returners to competition.

Results

Fourteen out of the 30 athletes included (46.7%) suffered secondary ACL injuries on average 29.4 ± 22.5 months after primary reconstruction. The secondary injuries comprised five re-ruptures (16.7%) and nine contralateral ACL tears (30.0%). The odds to suffer contralateral ACL tears were non-significantly higher in patients with hamstring tendon autografts (OR 5.69, n.s.) and in those whose primary injuries were classified as simple ACL tears (OR 5.31, n.s.). None of the factors assessed was associated with the odds of graft failure.

Conclusion

The odds of ACL-injured professional alpine ski racers to suffer secondary ACL tears are nearly 50%, with subsequent contralateral ACL injuries being more common than graft failures. While statistical significance could not be established due to a lack of power, greater odds of contralateral ACL tears were observed in athletes with hamstring tendon grafts as well as those with simple primary ACL injuries. No factors potentially predisposing athletes for graft failure could be identified.

Level of evidence

III.

中文翻译：

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对侧ACL撕裂在很大程度上导致专业滑雪运动员继发性ACL继发伤害。

目的

为了分析专业高山滑雪者的移植物选择，性别，损伤的复杂性和恢复比赛的时间对继发性ACL损伤（再次破裂或对侧ACL撕裂）的可能性的影响。

方法

筛选了一家专门的联合外科诊所的数据库，以查找在进行首次ACL重建之前曾参加FIS比赛，欧洲杯和世界杯比赛的专业高山滑雪者，并且他们在观察期结束前至少一年。对患有绳肌和四头肌腱自体移植的运动员，男性和女性，简单和复杂的（半月板或软骨累及）原发性ACL损伤，以及早期（初次重建后≤300天）和晚期（ > 300天）返回参赛者名单。

结果

在30名运动员中，有14名（46.7％）在初次重建后平均遭受了29.4±22.5个月的继发性ACL损伤。继发性损伤包括5次再破裂（16.7％）和9次对侧ACL撕裂（30.0％）。在绳肌腱自体移植患者中，对侧ACL撕裂的机率没有明显增加（OR 5.69，ns），在那些原发性损伤被分类为单纯ACL撕裂的患者中（OR 5.31，ns）。评估的因素均与移植失败的可能性无关。

结论

ACL受伤的专业高山滑雪选手遭受继发性ACL撕裂的几率接近50％，随后的对侧ACL损伤比移植失败更为普遍。尽管由于力量不足而无法确定统计学意义，但在绳肌腱移植以及单纯原发性ACL损伤的运动员中，对侧ACL撕裂的可能性更大。尚无潜在因素可能导致运动员发生移植失败。

证据水平

三，