Return to sport and knee functional scores after anterior cruciate ligament reconstruction: 2 to 10 years' follow-up

Background

Anterior cruciate ligament (ACL) reconstruction is one of the most common knee ligament reconstruction sustained by sports players. Previous studies have revealed different rates of returning to play sports depending on study sites, subjects, and time to follow-up; however, this subject has not been adequately investigated in Thailand.

Objectives

This study aimed to assess the percentage of ACL reconstruction patients who successfully returned to sport activities. Factors associated with being able to return to sport were also determined.

Materials and methods

A cross-sectional study was conducted to assess the rates of return to sport of patients who underwent ACL reconstruction between 2005 and 2015. All potential patients were initially contacted via letter or mobile phone and asked to report their long-term follow-up outcomes. Collected data from the interview, including return to sport status, performance following ACL, and reasons for not returning to play (if applicable) were then combined with the initial surgical findings and enrollment/follow-up cohort data for analysis. This study was reviewed and approved by the ethics committee of Rajavithi Hospital.

Results

A total of 110 participants were recruited, with a mean age of 35.05 ± 9.16 years. Most of the patients were male, single, with bachelor degree education, engaged in “other” occupations, had income up to 10,000 baht/month, were in the social security scheme (54.5%), and had no underlying diseases (85.5%). The mean ± SD of BMI was 25.58 ± 4.30 kg/m². When classified by whether or not they returned to sports, it was found that sex, education, income and underlying disease of those who returned to sport were significantly different from those of subjects who did not (p < 0.05). At follow-up, 36.4% had returned to sport. The main reasons stated for not returning to sport following ACL were fear of injury, concern about possible long-term effects, and worry about the possibility of re-injury. Overall, total IKDC scores of patients who returned to sport were significantly higher than those of subjects who did not. However, some points such as ability to kneel, ride and bend the knee were not different in the two groups. Bachelor degree education, monthly income lower than 10,000 Thai baht and IKDC score were the factors associated with returning to sport.

Conclusions

The rates of return to sport after ACL reconstruction were low compared to those of other reports in the literature. Education, low income and IKDC score were predictive factors of sport re-participation. Further studies should be carried out to assess the impact on treatment indications and rehabilitation.

Late dorsal tilt angulation of distal articular surface of radius in Colles' type of fracture at the end of the immobilization, can it be predicted?

BACKGROUND

The objective was to predict the late dorsal tilt angulation of distal articular surface of radius in Colles' type of fracture with radioulna index difference, age, sex of the patient and dorsal cortex comminution.

MATERIAL AND METHOD

Correlation between previously mentioned factors and the changing degree of dorsal tilt angulation of distal articular surface of radius were analyzed. Sixty three wrist radiographs of sixty two patients with Colles' type of fracture were evaluated for dorsal tilt angulation of distal articular surface, radioulna index before and after reduction and at the end of the immobilization, dorsal cortex comminution after reduction. The interobserver and intraobserver generalizability coefficients of the dorsal cortex comminution measurement method were analyzed.

RESULTS

Dorsal cortex comminution, age and sex of the patient were the predictors of the dorsal tilt angulation of distal articular surface of Colles' type of fracture at the end of the immobilization. Partial correlation coefficient for dorsal cortex comminution, age and sex were 0.177, 0.201 and -8.206 respectively. The generalizability coefficients were rated as substantial to excellent.

CONCLUSION

The late dorsal tilt angulation of distal articular surface of radius at the end of the immobilization can be predicted from size of dorsal cortex comminution, age and sex of the patients.

Factors affecting the redisplacement of the conservatively treated extra articular fractures of distal radius

BACKGROUND

The objective of the study was to predict the amount of radiographic dorsal tilt angulation of extra articular fracture of distal radius with the size of dorsal cortical bone defect, radioulna index difference, age and gender of the patient.

MATERIAL AND METHOD

Sixty two patients with close fracture of Colles type were treated by close reduction and short arm cast. They were evaluated radiographically for initial dorsal tilt angulation, initial radioulna index, radioulna index after reduction, dorsal cortical defect after reduction and dorsal tilt angulation at the end of immobilization at 4 to 6 weeks. Using the method of multiple regression analysis, The author tried to construct the equation to predict quantitatively the changing amount of dorsal tilt angulation of extra articular fracture of distal radius from the independent variables of dorsal cortical bone defect size, radioulna index difference, age and gender of the patients.

RESULTS

The presence of dorsal cortical bone defect,age and sex of the patient were found to be the predictors of the increased dorsal tilt angulation of distal radius. For the estimation of dorsal tilt angulation, the correlation coefficient for dorsal cortical bone defect size was 0.177, for age was 0.201, and female gender was -8.206. The radioulna index difference was not found to have correlation with increased dorsal tilt angulation of distal radius.

CONCLUSION

The increased dorsal tilt angulation of extra articular fracture of distal radius at 4-6 week after reduction can be predicted from the initial data on size of dorsal cortical bone defect, age and gender of the patients. The radioulna index difference did not show the significant correlation with increased dorsal tilt angulation of extra articular fracture of distal radius treated conservatively.