Return to Work or Sport After Multiligament Knee Injury: A Systematic Review of 21 Studies and 524 Patients.
Arthroscopy
; 34(5): 1708-1716, 2018 05.
Article
em En
| MEDLINE
| ID: mdl-29429563
ABSTRACT
PURPOSE:
To systematically review multiligament knee injury (MLKI) outcome studies to determine overall rates of return to work or sport after MLKI and risk factors for lack of return to work or sport after MLKI.METHODS:
A search was performed of MLKI outcome studies from 1950 to March 1, 2017. Ninety-two studies were identified. All included reported return to work, return to sport, or Tegner activity scores. Rates of return to work or sport were determined for overall population and by obesity status, injury severity, and presence of peroneal nerve or vascular injury.RESULTS:
A total of 524 patients (21 studies) were included. Return to high-level sport was low (22%-33%). Return to any level of sport was 53.6% overall (178/332), with a higher rate reported in studies with all surgical patients (59.1%, 114/193 patients) versus studies with mixed surgical and nonoperative treatment (46.0%, 64/139 patients) (P = .02). Rate of return to work with little or no modifications was 62.1% (146/200) and return to any work was 88.4% (190/215). Obese patients had lower postoperative Tegner scores than a general population (obese mean 1.7 ± 1.2; nonobese mean 4.5 ± 1.0; P < .001). Among studies without Schenck grade IV and V injuries, return to work with no or minimal modifications (100%, 12/12 patients) was higher than studies including grade IV and V patients (66.0%, 70/106 patients) (P = .017). Return to any work was higher in studies without vascular injuries (96.3%, 105/109) versus those including them (80.2%, 85/106) (P < .001).CONCLUSIONS:
Return to sport after MLKI occurs in approximately 60% of surgically treated patients, though return to high-level sport is lower. Return to work is frequently possible after MLKI though it may require workplace or job duty modifications. Obesity, nonoperative treatment, higher injury severity, and vascular injury are associated with poorer functional outcomes. LEVEL OF EVIDENCE Level IV, systematic review of level III and IV studies.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Retorno ao Trabalho
/
Volta ao Esporte
/
Traumatismos do Joelho
Tipo de estudo:
Prognostic_studies
/
Risk_factors_studies
/
Systematic_reviews
Limite:
Humans
Idioma:
En
Revista:
Arthroscopy
Assunto da revista:
ORTOPEDIA
Ano de publicação:
2018
Tipo de documento:
Article
País de afiliação:
Estados Unidos