Return to Play Following Anterior Cruciate Ligament Reconstruction

Morris, Ryan C.; Hulstyn, Michael J.; Fleming, Braden C.; Owens, Brett D.; Fadale, Paul D.

doi:10.1016/j.csm.2016.05.009

Cited by 20 publications

(11 citation statements)

References 62 publications

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“…The recent literature has popularized return-to-play criteria after anterior cruciate ligament (ACL) reconstruction, leading to increased acknowledgment that returnto-play criteria and/or timelines are lacking in the current orthopaedic literature. 44,46,55 It has been found that establishing precise criteria incorporating functional and dynamic testing to assess fine kinematics and neuromuscular control is essential before returning to high-level sports after ACL surgery 7,29,49,60 and may be beneficial in preventing reinjuries. As with ACL reconstruction, we aimed to begin the process of developing functional guidelines after MPFL reconstruction with the goals of decreasing reinjury rates and increasing patient satisfaction.…”

Section: Discussionmentioning

confidence: 99%

Return-to-Play Guidelines After Medial Patellofemoral Ligament Surgery for Recurrent Patellar Instability: A Systematic Review

Zaman¹,

White

Shi

et al. 2017

Am J Sports Med

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Section: Discussionmentioning

confidence: 99%

Return-to-Play Guidelines After Medial Patellofemoral Ligament Surgery for Recurrent Patellar Instability: A Systematic Review

Zaman¹,

White

Shi

et al. 2017

Am J Sports Med

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“…These patients had better results in the evaluation of functional tests, pain, quality of life questionnaires and symptoms. 3 In a recent review, the MRI graft signal with six months of ACLR was evaluated and repeated with 12 months in parallel to the IKDC questionnaire. They observed that in the evolution from six to 12 months there was a decrease in the signal on MRI, and an improvement in the IKDC score.…”

Section: Image Criteriamentioning

confidence: 99%

“…1 With the evolution of surgical techniques and rehabilitation/ training protocols, there is currently an increase in the number of athletes who return to pre-injury sports after surgery for ACL reconstruction (ACLR). 2,3 The return to play (RTP) can be defined as the time necessary for the post-ACLR athlete to be able to compete at the same previous level. 4 For many years, the determining criterion for the RTP post-ACLR was the six-month period elapsed.…”

Section: Introductionmentioning

confidence: 99%

“…4 For many years, the determining criterion for the RTP post-ACLR was the six-month period elapsed. 3 However, recent findings discourage using the temporal criterion in isolation. [5][6][7][8] The current trend is to characterize the RTP as a continuous process with three subphases: return to participation, return to playing and return to performance.…”

Section: Introductionmentioning

confidence: 99%

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Return to Play After Anterior Cruciate Ligament Reconstruction

Goes

Cossich

França

et al. 2020

Rev Bras Med Esporte

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The anterior cruciate ligament (ACL) tear represents more than half of all knee injuries in sports that involve body rotations and sudden changes of direction. Discharging the athlete for return to play (RTP) post-ACL reconstruction (ACLR) is a difficult task with multidisciplinary responsibility. For many years, a six-month period post-ACLR was adopted as the only criterion for RTP. However, it is now suggested that RTP should not be exclusively time-based, but to clinical data and systematic assessments. Despite the importance of post-ACLR factors for RTP, pre- and peri-ACLR factors must also be considered. Historically, ACLR is performed with the hamstring or autologous patellar tendons, although the choice of graft is still an open and constantly evolving theme. Anterolateral ligament reconstruction and repair of meniscal ramp tear associated with ACLR have recently been suggested as strategies for improving knee joint stability. Subjective questionnaires are easy to apply, and help identify physical or psychological factors that can hamper RTP. Functional tests, such as hop tests and strength assessment by means of isokinetic dynamometers, are fundamental tools for decision making when associated with clinical evaluation and magnetic resonance imaging. Recently, the capacity to generate force explosively has been incorporated into the muscle strength assessment. This is quantified through the rate of torque development (RTD). Due to characteristics inherent to the practice of sport, there is an extremely short time available for produce strength. Thus, RTD seems to better represent athletic demands than the maximum strength assessment alone. This review investigates the pre-, peri- and post-ACLR factors established in the literature, and shares our clinical practice, which we consider to be best practice for RTP. Level of evidence V; Specialist opinion.

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“…The anterior cruciate ligament (ACL) reconstruction is an effective method to treat ACL injury in order to restore knee stability, decrease risk of medial meniscal tears 1 and improve functional outcome. Approximately 200,000 ACL reconstructions were performed in the United States alone each year 2 .…”

Section: ■ Introductionmentioning

confidence: 99%

Tibial tunnel enlargement and joint instability after anterior cruciate ligament reconstruction. A prospective comparison between autograft and allograft

Zhang

Hao

et al. 2017

Acta Cir. Bras.

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IVTibial tunnel enlargement and joint instability after anterior cruciate ligament reconstruction. A prospective comparison between autograft and allograft 1 Abstract Purpose: To investigate tibial tunnel widening and knee instability after ACL reconstruction with hamstring autograft or irradiated soft tissue allograft. Methods: Eight-two patients were divided into two groups: autograft group and allograft group. Radiographic and clinical evaluations were performed. Results: Seventy patients were followed up with median of 36.3 months (range 36-38 months). Tibial tunnel widening was at or greater than 30% for nine patients in the autograft group and 15 patients in the allograft group (P = 0.0417). The average percentage of tibial tunnel widening was 26.7 ± 4.0 % and 29.7 ± 5.3 % in autograft and allograft groups, respectively (P = 0.0090). Knee range of motion was not affected by the reconstruction operation or different grafts. Thigh atrophy improved significantly within 24 months after ACL reconstructions in both groups. ACL reconstruction with the allograft leaded to less knee stability than that with the autograft from one year after operation (P = 0.0023). There was no significant difference between two groups with respect to Lysholm score (P = 0.1925) and Tegner score (P =0 .0918) at the final follow-up. Conclusion:The allograft group reported significantly more tibial tunnel widening and knee instability compared with the autograft group.

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Return to Play Following Anterior Cruciate Ligament Reconstruction

Cited by 20 publications

References 62 publications

Return-to-Play Guidelines After Medial Patellofemoral Ligament Surgery for Recurrent Patellar Instability: A Systematic Review

Return-to-Play Guidelines After Medial Patellofemoral Ligament Surgery for Recurrent Patellar Instability: A Systematic Review

Return to Play After Anterior Cruciate Ligament Reconstruction

Tibial tunnel enlargement and joint instability after anterior cruciate ligament reconstruction. A prospective comparison between autograft and allograft

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