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Master Thesis

Évaluation objective de la reprise sportive et aptitude chez le militaire après ligamentoplastie du croisé antérieur

Abstract : Introduction: the anterior cruciate ligament (ACL) injury is a pathology frequently encountered in athletes, and therefore in soldiers. Surgical management by ACL reconstruction requires several months of rehabilitation with progressive return-to-sport activities. Several studies have focused on the return to sport, always through self-reported questionnaires. The main purpose of our study was to determine as objectively as possible, the rate of return to sport in soldiers at their preinjury level after ACL reconstruction, using military annual sport tests. Method: Our study is retrospective, non-interventional and based on medical records. All patients were military active duty people and did their medical follow-up at Laveran Army Teaching Hospital in Marseille. Results of military annual sport tests were collected in order to compare the sport level before and after ACL reconstruction surgery. The main endpoint was defined as an identical or superior sport test result after surgery compared to the same sport test performed before ACL reconstruction. The secondary endpoint was defined as two identical or superior sport tests results after ACL surgery. A military patient was considered to return to his preinjury sport level if he met the conditions of the primary endpoint. Several variables were studied to identify factors that could influence the return to the preinjury level of sport. Results: 177 military patients were included between January 2011 and December 2017 (94.92% men with a median age of 27.60 years). Among the 144 patients analysed on the primary endpoint, 40.28% returned to their preinjury level of sport after ACL surgery. Among the soldiers who did not return to their preinjury level of sport, 24.29% were medically discharged. High BMI, an isokinetic test at the 8th-9th month with a deficit superior to 30%, long sick leave, late return to military activities (sedentary work and full duty) and type of surgery (semitendinosus and gracilis tendon compared to four-strand single semitendinosus) were associated with a poorer quality of return to sport after ACL reconstruction. Conclusion: Anterior cruciate ligament injury has a significant impact on the operational capability of the French armed forces. The rate of return to sport at the preinjury level after ACL surgery, evaluated objectively by annual sports tests, is 40% in the military patient. Several factors seem relevant to us to be considered in the follow-up of patients in order to optimise their recovery of sport performance and therefore their operational ability.
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Submitted on : Thursday, August 27, 2020 - 12:50:06 PM
Last modification on : Friday, October 23, 2020 - 4:58:55 PM
Long-term archiving on: : Saturday, November 28, 2020 - 12:33:00 PM


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Florent Trescos. Évaluation objective de la reprise sportive et aptitude chez le militaire après ligamentoplastie du croisé antérieur. Sciences du Vivant [q-bio]. 2020. ⟨dumas-02923673⟩



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