Background:Long-term outcomes for isolated anterior cruciate ligament (ACL) reconstructions in competitive American football athletes are well reported in the literature, but little data currently exist regarding multiligament knee injury (MLKI) reconstruction outcomes.Purpose:To examine patient-reported and return-to-sport outcomes of competitive American football athletes who underwent primary, single-staged, multiligament knee reconstruction.Study Design:Case series; Level of evidence, 4Methods:We identified patients from our institution’s prospectively collected data repository between 2001 and 2020 who underwent single-staged surgical reconstruction of an MLKI sustained during competitive participation in American football. We assessed patient-reported outcomes at a minimum of 2 years after surgery using the International Knee Documentation Committee (IKDC) Subjective Knee Form and questions regarding surgical satisfaction and return to sport. Successful return to sport was defined as a return to preinjury level of competition. We summarized all outcome data and compared outcomes between 2-ligament and >2-ligament groups and between ACL-only MLKI injury and bicruciate MLKI injury groups using independent t test for IKDC scores and chi-square test for return to sport. Additionally, we evaluated predictors of postoperative IKDC scores using linear regression and predictors of return to sport using logistic regression.Results:Outcome data were successfully collected for 53 of 73 total eligible patients (73%; mean follow-up time, 7.7 ± 4.0 years; all male; mean age at surgery, 18.1 ± 2.7 years). The mean postoperative IKDC score was 84 ± 16. The most common level of preinjury competition was high school (n = 36; 68%), followed by college (n = 10; 19%). Seven patients did not return to sport competition at any level due to limitations from their knee surgery, and 82% of patients that attempted to return to preinjury level of sport were able to do so. A total of 50 patients (94%) were satisfied or very satisfied with their surgical outcome. The 2-ligament (n = 39) and >2-ligament (n = 14) groups did not significantly differ in IKDC scores ( P = .96) or proportions with successful return to sport ( P = .77). Similarly, the ACL-MLKI injury (n = 39) and bicruciate MLKI injury (n = 14) groups did not significantly differ in IKDC scores ( P = .89) or proportions with successful return to sport ( P = .77). Age and body mass index were not significantly associated with IKDC scores or successful return to sport at follow-up (all P > .05).Conclusion:This study may represent the largest cohort of competitive American football athletes evaluated for longitudinal outcomes after multiligament knee reconstruction. Despite the severity of these injuries, we found good knee-related function and that the large majority of athletes who attempted to return to sport were successful. The majority of athletes (94%) were satisfied with their operative treatment.

中文翻译：

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美式足球运动员多韧带膝盖损伤的长期结果


背景：文献中详细报道了美国橄榄球运动员孤立前十字韧带 (ACL) 重建的长期结果，但目前关于多韧带膝损伤 (MLK​​I) 重建结果的数据很少。目的：检查患者报告的和研究设计：案例系列；接受初级、单阶段、多韧带膝关节重建的美国橄榄球运动员恢复运动的结果。证据水平，4 种方法：我们从我们机构前瞻性收集的数据存储库中确定了 2001 年至 2020 年期间接受单阶段 MLKI 手术重建的患者，这些患者在参加美式橄榄球比赛期间持续存在 MLKI。我们使用国际膝关节文献委员会 (IKDC) 主观膝关节表格以及有关手术满意度和恢复运动的问题，评估了患者在手术后至少 2 年报告的结果。成功重返运动被定义为恢复到受伤前的比赛水平。我们总结了所有结果数据，并使用 IKDC 评分的独立 t 检验和恢复运动的卡方检验，比较了 2 韧带组和 > 2 韧带组之间以及仅 ACL MLKI 损伤和双十字 MLKI 损伤组之间的结果。此外，我们使用线性回归评估术后 IKDC 评分的预测因素，并使用逻辑回归评估恢复运动的预测因素。结果：成功收集了 73 名符合条件的患者中的 53 名患者的结果数据（73%；平均随访时间为 7.7 ± 4.0 年） ；均为男性；手术时平均年龄为 18.1 ± 2.7 岁）。术后 IKDC 平均评分为 84 ± 16。最常见的受伤前比赛水平是高中（n = 36；68%），其次是大学（n = 10；19%）。 7 名患者由于膝盖手术的限制而未能恢复任何级别的运动比赛，而 82% 试图恢复到受伤前运动水平的患者能够做到这一点。共有 50 名患者 (94%) 对手术结果感到满意或非常满意。 2 韧带 (n = 39) 和 > 2 韧带 (n = 14) 组在 IKDC 评分 ( P = .96) 或成功恢复运动的比例 ( P = .77) 方面没有显着差异。同样，ACL-MLKI 损伤 (n = 39) 和双十字 MLKI 损伤 (n = 14) 组在 IKDC 评分 (P = .89) 或成功恢复运动的比例 (P = .77) 方面没有显着差异。年龄和体重指数与 IKDC 分数或随访时成功恢复运动没有显着相关性（所有 P > .05）。 结论：这项研究可能代表了对多韧带膝关节术后纵向结果进行评估的最大的竞技美式橄榄球运动员队列重建。尽管这些损伤很严重，但我们发现膝盖相关功能良好，并且大多数试图重返运动的运动员都取得了成功。大多数运动员（94%）对手术治疗感到满意。