L’ajout d’une plastie extra-articulaire à la reconstruction du LCA réduit significativement les taux de rupture de greffe : étude rétrospective comparative de skieurs alpins professionnels de l’équipe de France - 30/11/21
Adding a lateral extra-articular procedure at the time of ACL reconstruction significantly reduces graft rupture rates: A retrospective comparative study of elite Alpine skiers from the French National Team
, Jean-Marie Fayard 1, Adnan Saithna 3, Sami Bahroun 2, Alexandre Ferreira 2, Alessandro Carrozzo 4, Stephane De Jesus 5, Stephane Bulle 5, Thais Dutra Vieira 1Résumé |
Introduction |
Elite Alpine ski is associated with a particularly high risk of anterior cruciate ligament (ACL) injuries (including graft ruptures). Despite a considerable focus on prevention a reduction in injury rates has not been observed since the 1980s.
Matériel et méthode |
Elite skiers from the french ski team who had undergone ACL reconstruction, with or without a lateral extra-articular procedure (LEAP), and had a minimum follow-up of 2 years, were identified from the national ski team database. Rates of secondary ACL injury were determined by interrogation of the database, medical notes review and a final telemedicine interview. A multivariate analysis using the penalized Cox model was performed to explore the relationship between the graft rupture, surgical procedure type and any potential explanatory variables.
Résultats |
Among 81 ACLR procedures analyzed, 50 were performed in an isolated manner (isolated ACLR group) and 31 were combined with a LEAP (ACLR+LEAP group), which was performed using either modified Lemaire or anterolateral ligament reconstruction (ALLR). Graft rupture rates were 34.0% in the isolated ACLR group and 6.5% in the ACLR+LEAP group. Multivariate analysis demonstrated that adding a lateral extra-articular procedure significantly reduced the risk of ACL graft rupture when compared to isolated ALCR (Hazard Ratio (HR)=5.286, IC 95% [1.068; 26.149], p=0.0412). Age (HR=1.114, p=0.1157), Gender (HR=1.573, p=0.3743) and ACL graft Type (HR=1.417, p=0.5394) were not found to be significant risk factors.
Conclusions |
Combined ACLR and lateral extra-articular procedures confer a significant 5.3 times reduction in the rate of ACL graft rupture in elite alpine ski athletes. Those treated with isolated ACLR remain at extremely high risk of second ACL injury.
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Vol 107 - N° 8S
P. S277 - décembre 2021 Retour au numéro
Article précédent
- Facteurs de risque anatomiques de la rupture du LCA dans les traumatismes sans contact ?
- Michel Vancabeke, Lucas Abdelkafi, Karim Abdelkafi, Nicolas Vandenbalck
- Reconstruction combinée intra et extra-articulaire du LCA : aucune différence entre fascia lata augmenté au droit interne et DIDT avec ténodèse latérale, sauf sur le taux d’arthrolyse. Une étude prospective contrôlée de la cohorte FAST
- Adrien Saint-Etienne, Alexandre Hardy, Nicolas Lefevre, Alain Meyer, Olivier Grimaud, Antoine Gerometta, Yoann Bohu
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