After anterior cruciate ligament reconstruction (ACLR), return to sport is high in competitive wresting, according to a new study.
Return to Competitive Wrestling After ACLR High
2 min read Premium comments
Secondary#returntosport#anteriorcruciateligamentreconstruction#competitivewrestling
The study, “Anterior Cruciate Ligament Reconstruction in 107 Competitive Wrestlers: Outcomes, Reoperations, and Return to Play at 6-Year Follow-up,” was published on May 5, 2022, in the Orthopaedic Journal of Sports Medicine.
“Wrestling is a physically demanding sport, with young athletes prone to anterior cruciate ligament injuries. There is a paucity of data evaluating the results of anterior cruciate ligament reconstruction in this cohort,” the researchers wrote.
They analyzed return to sport, patient-reported outcomes, reoperation rates, and graft survival after anterior cruciate ligament reconstruction at midterm follow-up.
The competitive wrestlers involved in the study were either club, high school, collegiate, or professional players with a history of an anterior cruciate ligament reconstruction who had their surgery at a single institution between 2000 and 2019.
The researchers defined graft failure as a retear and/or revision anterior cruciate ligament reconstruction. Patient-reported outcomes included pain Visual Analog Scale, International Knee Documentation Committee, and Tegner activity scores.
Overall, 103 wrestlers and 107 knees were included in the analysis. Median follow-up time was 5.9 years (interquartile range [IQR], 3.9-10.3 years). Median age was 17 years. The majority of the patients were male.
Sixty-four of the patients received a bone-patellar tendon-bone autograft and 43 a hamstring tendon autograft. At the final follow-up, 80% of the wrestlers had return to competition at a median of 280 days (IQR, 212-381 days).
Graft failure occurred in 14 knees at a median time of 1.8 years (IQR, 0.7-5.3 years) after the index procedure. There was a lower failure rate with bone-patellar tendon-bone autograft compared with hamstring tendon autograft (8% vs. 21%; p = .044). Bone-patellar tendon-bone autograft was also associated with better survival up to five years after the index anterior cruciate ligament reconstruction (90.4% vs 76.3%; p = .030).
When the researchers compared graft diameter, they found that hamstring tendon autografts of at least 7.5 mm were not associated with a lower graft failure than bone-patellar tendon-bone autograft constructs of all sizes (p = .205).
Study authors included Erick M. Marigi, M.D., Bryant M. Song, M.S., Jory N. Wasserburger, M.D., Christopher L. Camp, M.D., Bruce A. Levy, M.D., Michael J. Stuart, M.D., Kelechi R. Okoroha, M.D., and Aaron J. Krych, M.D., all of the Mayo Clinic in Rochester, Minnesota.
React:
Discussion
This is a fascinating development. In my practice we've seen similar outcomes with the revised protocol. The key differentiator seems to be patient selection criteria. Has anyone else noticed the correlation with BMI thresholds?
Great point. I'd push back slightly on the conclusion, the sample size in the cited study is too small to draw population-level inferences. That said, the directional signal is compelling and worth a larger RCT.
We implemented a similar approach last year. Early results are promising but we're still gathering 12-month follow-up data. Happy to share our protocol if anyone is interested.
Join the conversation
Orthopedic professionals are discussing this. Sign in and upgrade to read every comment and add your voice.