Return to Sports after Anterior Cruciate Ligament Injury: a Matched-Pair Analysis of Repair with Internal Brace and Reconstruction Using Hamstring or Quadriceps Tendons

Reinhold Ortmaier; Christian Fink; Wolfgang Schobersberger; Harald Kindermann; Iris Leister; Armin Runer; Caroline Hepperger; Cornelia Blank; Georg Mattiassich

doi:10.1055/a-1019-0949

Sportverletzung · Sportschaden, Inhaltsverzeichnis

Sportverletz Sportschaden 2021; 35(01): 36-44
DOI: 10.1055/a-1019-0949

Originalarbeit

Return to Sports after Anterior Cruciate Ligament Injury: a Matched-Pair Analysis of Repair with Internal Brace and Reconstruction Using Hamstring or Quadriceps Tendons

Rückkehr zum Sport nach Ruptur des vorderen Kreuzbandes. Eine Matched-paired-Studie nach Kreuzbandnaht mittels Internal Brace und Ersatzplastik mittels Hamstring- oder Quadrizepssehne

Reinhold Ortmaier

¹Department of Orthopedic Surgery, Institution Ordensklinikum Barmherzige Schwestern Linz, Vinzenzgruppe Center of Orthopedic Excellence, Teaching Hospital of the Paracelsus Medical University Salzburg

,

Christian Fink

²Gelenkpunkt – Sports and Knee Surgery Innsbruck

,

Wolfgang Schobersberger

³Institute of Sports Medicine, Alpine Medicine and Health Tourism (ISAG), Tirol Kliniken GmbH, Innsbruck and UMIT Hall, Austria

,

Harald Kindermann

⁴University of applied science upper Austria

,

Iris Leister

⁵Institute of Molecular Regenerative Medicine, Spinal Cord Injury and Tissue Regeneration Center Salzburg, Paracelsus Medical University Salzburg, Austria

,

Armin Runer

⁶Institute for Sports Medicine, Alpine Medicine and Health Tourism (ISAG) Hall in Tirol; Medical University Innsbruck

,

Caroline Hepperger

⁷Institute of Sports Medicine, Alpine Medicine and Health Tourism (ISAG), Hall in Tirol

,

Cornelia Blank

⁷Institute of Sports Medicine, Alpine Medicine and Health Tourism (ISAG), Hall in Tirol

,

Georg Mattiassich

⁸Trauma Center Linz; Trauma Center Graz; Department of Orthopedic Surgery, Ordensklinikum Barmherzige Schwestern Linz, Vinzenzgruppe Center of Orthopedic Excellence, Teaching Hospital of the Paracelsus Medical University Salzburg

› Institutsangaben

Abstract

Purpose The purpose of this study was to evaluate sports activity before anterior cruciate ligament (ACL) injury and after surgical treatment of ACL rupture comparing ACL repair with an Internal Brace to ACL reconstruction using either a hamstring (HT) or quadriceps tendon (QT) autograft.

Methods Between 12/2015 and 10/2016, we recruited 69 patients with a mean age of 33.4 years for a matched-pair analysis. Twenty-four patients who underwent Internal Brace reconstruction were matched according to age (± 5 years), gender, Tegner activity scale (± 1), BMI (± 1) and concomitant injuries with 25 patients who had undergone HT reconstruction and 20 patients who had undergone QT reconstruction. The minimum follow-up was 12 months.

Results Overall, the return-to-sports rate was 91.3 %. There were no significant differences (p ≥ 0.05) in the number of sports disciplines and the time before return to sports within or among the groups. Overall and within the groups, the level of sports participation did not change significantly (p ≥ 0.05) postoperatively. The patients' sense of well-being was excellent after either ACL repair with an Internal Brace or ACL reconstruction with autologous HT or QT.

Conclusion At short-term follow-up, ACL repair using an Internal Brace enables sports activity and provides a sense of well-being similar to that of classic ACL reconstruction using hamstring or quadriceps tendon autografts in a selected patient population. Level of Evidence: Level III Retrospective comparative study.

Zusammenfassung

Hintergrund Der Hintergrund für diese Studie war es, die Sportfähigkeit vor vorderer Kreuzbandruptur und nach operativer Versorgung mittels Kreuzbandnaht durch Internal Brace und Kreuzbandersatzplastik mittels Hamstring- oder Quadrizepssehne zu ermitteln.

Methoden Zwischen 12/2015 und 10/2016 wurden 69 Patienten mit einem mittleren Alter von 33,4 Jahren für diese Matchted-paired-Analyse eingeschlossen. 24 Patienten, die mittels Internal Brace durch Kreuzbandnaht versorgt wurden, sind gemäß ihres Alters (± 5 Jahre), ihres Geschlechts, ihrer Tegner activity scale (± 1), ihres BMI (± 1) und ihrer Begleitverletzungen mit 25 Patienten, welche mittels Hamstringsehnenersatzplastik und 20 Patienten, welche mittels Quadrizepssehnenersatzplastik versorgt wurden, gematched und verglichen worden. Der minimale Nachuntersuchungszeitraum betrug 12 Monate.

Resultate Insgesamt betrug die Return-to-sports-Rate 91,3 %. Zwischen und innerhalb der Gruppen gab es keinen signifikanten Unterschied (p ≥ 0,05) in der Anzahl der Sportdisziplinen und bezüglich des Zeitpunktes der Rückkehr zum Sport. Das Level, auf dem Sport betrieben wurde, änderte sich nicht signifikant (p ≥ 0,05) innerhalb und zwischen den Gruppen. Das Wohlbefinden der Patienten war bei allen Verfahren, sowohl nach Kreuzbandnaht mit Internal Brace als auch nach Kreuzbandrekonstruktion mit Hamstringsehnen und Quadrizepssehne, exzellent.

Schlussfolgerung Im Kurzzeitverlauf konnte gezeigt werden, dass die Naht des vorderen Kreuzbandes mittels Internal Brace die Rückkehr zum Sport ermöglicht und ein subjektives Wohlbefinden bei sportlicher Aktivität, ähnlich wie nach klassischen Rekonstruktionsverfahren mit Hamstring- oder Quadrizepssehne, im untersuchten Patientengut gewährleistet. Evidenzlevel: Level III Retrospektive Matched-paired-Studie.

Key words

ACL repair - ACL reconstruction - internal Brace - hamstring - quadriceps

Schlüsselwörter

VKB-Naht - VKB-Rekonstruktion - Internal Brace - Hamstring - Quadrizeps

Volltext

Referenzen

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