Article

A timely return to competitive sport is a primary goal of anterior
cruciate ligament reconstruction (ACLR). It is not known whether an accelerated
return to sport increases the risk of early-onset knee osteoarthritis (KOA).
OBJECTIVE: To determine whether an accelerated return to sport post-ACLR (ie, <10
months) is associated with increased odds of early KOA features on magnetic
resonance imaging (MRI) 1 year after surgery and to evaluate the relationship
between an accelerated return to sport and early KOA features stratified by type
of ACL injury (isolated or concurrent chondral/meniscal injury) and lower limb
function (good or poor). DESIGN: Cross-sectional study. SETTING: Private
radiology clinic and university laboratory. PARTICIPANTS: A total of 111
participants (71 male; mean age 30 +/- 8 years) 1-year post-ACLR. METHODS:
Participants completed a self-report questionnaire regarding postoperative
return-to-sport data (specific sport, postoperative month first returned), and
isotropic 3-T MRI scans were obtained. OUTCOME MEASURES: Early KOA features (bone
marrow, cartilage and meniscal lesions, and osteophytes) assessed with the MRI OA
Knee Score. Logistic regression analyses evaluated the odds of early KOA features
with an accelerated return to sport (<10 months post-ACLR versus >/=10 months or
no return to sport) in the total cohort and stratified by type of ACL injury and
lower limb function. RESULTS: Forty-six (41%) participants returned to
competitive sport <10 months post-ACLR. An early return to sport was associated
with significantly increased odds of bone marrow lesions (odds ratio [OR] 2.7,
95% confidence interval [CI] 1.3-6.0) but not cartilage (OR 1.2, 95% CI 0.5-2.6)
or meniscal lesions (OR 0.8, 95% CI 0.4-1.8) or osteophytes (OR 0.6, 95% CI
0.3-1.4). In those with poor lower limb function, early return to sport
exacerbated the odds of bone marrow lesions (OR 4.6, 95% CI 1.6-13.5), whereas
stratified analyses for type of ACL injury did not reach statistical
significance. CONCLUSION: An accelerated return to sport, particularly in the
presence of poor lower limb function, may be implicated in posttraumatic KOA
development. LEVEL OF EVIDENCE: IV.
CI - Copyright (c) 2018 American Academy of Physical Medicine and Rehabilitation.
Published by Elsevier Inc. All rights reserved.

Langue : ANGLAIS