Bone fragment absorption was seen in all of the shoulders with bony Bankart lesions. Most bone fragments showed severe absorption within 1 year after the primary traumatic episode. Before arthroscopic Bankart repair, not only glenoid defects but also bone fragment absorption should be assessed.
Purpose
This study aimed to identify independent predictive factors for return to sports (RTS) after anterior cruciate ligament (ACL) reconstruction in competitive‐level athletes and to determine optimal cut‐off values for these factors at 6 months after surgery.
Methods
A total of 124 competitive athletes (50 males and 74 females; mean age, 17.0 years; preinjury Tegner activity scale > 7) who underwent primary ACL reconstruction were enrolled. Assessments at 6 months after surgery consisted of knee functional tests [quadriceps index, hamstrings index, and single‐leg hop for distance (SLH)] and 2 self‐report questionnaires [IKDC subjective score and ACL‐Return to Sport after Injury scale (ACL‐RSI)]. At 1 year after surgery, athletes were classified into the RTS group (n = 101) or non‐RTS group (n = 23) based on self‐reported sports activities. After screening possible predictive factors of RTS, multivariate logistic regression and receiver operating characteristic curve analyses were performed to identify independent factors.
Results
Multivariate logistic regression analysis identified SLH (odds ratio, 2.861 per 10 unit increase; P < 0.001) and ACL‐RSI (odds ratio, 1.810 per 10 unit increase; P = 0.001) at 6 months as independent predictors of RTS at 1 year after surgery. Optimal cut‐off values of SLH and ACL‐RSI were 81.3% (sensitivity = 0.891; specificity = 0.609) and 55 points (sensitivity = 0.693; specificity = 0.826), respectively.
Conclusion
In competitive athletes, SLH < 81% and ACL‐RSI < 55 points at 6 months after surgery were associated with a greater risk of unsuccessful RTS at 1 year after surgery. SLH and ACL‐RSI at 6 months could serve as screening tools to identify athletes who have difficulties with returning to sports after ACL reconstruction.
Level of evidence
III.
A radial tear of 100% width involving the rim significantly decreased the in situ force of the lateral meniscus and caused medial shift and valgus rotation of the tibia, whereas a radial tear of up to 66% width produced only little change. The clinical relevance is that loss of meniscal functions due to complete radial tear can lead to abnormal stress concentration in a focal area of cartilage and can increase the risk of osteoarthritis in the future.
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