Relation of Anterior Cruciate Ligament Tears to Potential Chronic Cardiovascular diseases - 13/11/18
Résumé |
We have enrolled a cohort of former National Football League players (n = 3,506) who played since 1960 to assess potential long term health consequences associated with participating in the sport. Each participant has completed a self-administered questionnaire including reporting of physician-diagnosed health conditions. One of the early assessments was to evaluate whether anterior cruciate ligament (ACL) tears were associated with later life co-morbidities, including cardiovascular effects. We used Cox proportional hazards to estimate hazard ratios (HR) for joint replacement surgeries, myocardial infarction, sleep apnea, arthritis, dementia, and stroke by history of ACL tear during their professional career. For additional outcomes without date of occurrence reported we used logistic regression to estimate odds ratios adjusted for potential confounding variables in all models. After adjusting for covariates, former National Football League players who tore their ACL had approximately a twofold increase in muscular skeletal co-morbidities, including knee joint replacement and arthritis, compared with those without ACL tears. In addition, those with a history of ACL tears also had more than a 50% increased risk of myocardial infarction (HR 1.52; 95% confidence interval 0.97 to 2.38) and a slight increase in sleep apnea (HR 1.15; 95% confidence interval 0.96 to 1.38). ACL tears sustained by athletes may increase the risk of co-morbidities beyond the musculoskeletal system. As there are more than 100,000 ACL reconstructions annually in the United States, our findings could have widespread public health importance if these findings generalize to a population beyond professional football players. In conclusion, enhanced screening for other risk factors for these conditions in patients who have torn their ACL might identify those who could most benefit from prevention strategies.
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Source of Funding: Dr. Zafonte receives royalties from (1) Oakstone for an educational CD-Physical Medicine and Rehabilitation a Comprehensive Review; (2) Demos publishing for serving as coeditor of the text Brain Injury Medicine. Dr. Zafonte serves on the Scientific Advisory Board of Oxeia Biopharma and Myomo. He also evaluates patients in the MGH Brain and Body-TRUST Program which is funded by . Dr. Zafonte was partially supported by: NIDLIRR: 90DP0039-03-00, 90SI5007-02-04,90 D P0060; USAMRC-W81XWH-1120210, NIH: 4 U01NS086090-04; 5R24HD082302-02;5U01NS091951-03 and by a grant from the Football Players Health Study at Harvard University, which is funded by the NFL Players AssociationDr. A. Pascual-Leone was partly supported by the Sidney R. Baer Jr. Foundation, the NIH (R01MH100186, R01HD069776, R01NS073601, R21 NS082870, R21 MH099196, R21 NS085491, R21 HD07616), the Football Players Health Study at Harvard University, and Harvard Catalyst | The Harvard Clinical and Translational Science Center (NCRR and the NCATS NIH, UL1 RR025758). Grant Support: The Football Players Health Study is funded by a grant from the National Football League Players Association (Washington, DC, USA). |
Vol 122 - N° 11
P. 1879-1884 - décembre 2018 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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