Международный журнал физической медицины и реабилитации

Международный журнал физической медицины и реабилитации
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ISSN: 2329-9096


Influence of Graft Type and Meniscal Involvement on Return to Sport Outcomes six Months after Anterior Cruciate Ligament Reconstruction

Casey Moler, Kevin Cross, Mandeep Kaur, Amelia Bruce, Joe Hart, David Diduch, Miller Mark, Brian Werner, Winston Gwathmey

Background: The purpose of this study was to compare the return to sport outcomes at six months after ACLR between meniscus procedures, ACLR (ACLR-only), ACLR with meniscectomy (ACLR-resect), and ACLR with meniscal repair (ACLR-repair) for bone patellar tendon bone grafts and hamstring tendon grafts, separately.

Methods: This cross-sectional study included 314 participants (168 female; mean ± SD age, 19.7 ± 4.8) with ACLR with a BPTB or HT. Patients were divided into three groups depending on meniscal procedure. Multivariate analysis of covariance compared differences between meniscal procedures on the battery of tests, and for each statistically significant variable, an analysis of covariance assessed the effect of meniscal procedure within each graft type. Logistic regression assessed the influence of meniscal procedure on tests’ pass rates defined as 90% of limb symmetry index (90% LSI). Tests that were statistically significant were independently analyzed by a separate logistic regression for each graft type.

Results: BPTB: ACLR-only had greater hamstring strength than ACLR-resect (p=0.05) and ACLR-repair (p=0.005). ACLR-only was more likely to pass the hamstring strength test than ACLR-resect (OR (95% CI) (2.52 (1.32, 4.82), p=0.01) and ACLR-repair (2.29 (1.07, 4.90), p=0.01). HT: ACLR-only (p=0.03) and ACLR-resect (p=0.003) had higher IKDC scores than ACLR-repair.

Conclusion: The influence of meniscal repair on clinical outcomes is dependent on the graft choice. Rehabilitation following ACLR with BPTB and a meniscal procedure should emphasize hamstring function for optimal short-term recovery.