Return to Sport-Specific Performance After Primary Anterior Cruciate Ligament Reconstruction: A Systematic Review

Mohtadi, Nicholas G.; Chan, Denise

doi:10.1177/0363546517732541

Cited by 68 publications

(72 citation statements)

References 36 publications

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“…Compared to matched controls, a considerable lower share was still engaged in competitive football at 5 years post‐RTP, especially with regard to the same level of competition. A recently published systematic review revealed comparable amounts for total RTP rates: Depending on the source and type of sport, two‐third to all top‐level professional athletes successfully were found to return to their sport …”

Section: Discussionmentioning

confidence: 99%

Return to play, performance, and career duration after anterior cruciate ligament rupture: A case–control study in the five biggest football nations in Europe

Niederer

Engeroff

Wilke

et al. 2018

Scandinavian Med Sci Sports

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A media-based collection and further analysis of relative return to play (RTP) rates and the corresponding quality of play after anterior cruciate ligament (ACL) rupture in top-level football was the aim of our study. In the 5-year case-control study, male players from the first two leagues of the five top leagues in Europe, who sustained a total ACL rupture during the season 2010/11 and/or 2011/12, were included. For them and a matched control sample (ratio 1:2), data were retrieved from the publicly available and validated media-based platforms (transfermarkt.de & whoscored.com) until the end of season 2016/17. Injury and return to play-specific data were calculated as rate ratios (RR) to compare the injured and matched control athletes rates and as a survival analysis (log-rank test; career duration). Overall, 132 ACL-injuries in 125 players occurred. The RTP rate was 98.2%, and the RTP to the same level was 59.4%. Five years post-RTP, 69.9% of the ACL group were still engaged in football (RR = 87%), 40.9% at the same level (RR = 72%). Survival analysis revealed a systematic group difference in career duration compared to controls (Cox-Mantel's χ = 5.8; P = 0.016). Game performance (scoring points, P < 0.001; rates/number of completed passes, P = 0.048; and minutes played, P < 0.001) was lower in the ACL athletes than in the matching group in the RTP and post-RTP seasons. Although absolute and relative RTP rates after ACL reconstruction are high in professional football, career duration and game performance are lower than in the reference group.

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Section: Discussionmentioning

confidence: 99%

Return to play, performance, and career duration after anterior cruciate ligament rupture: A case–control study in the five biggest football nations in Europe

Niederer

Engeroff

Wilke

et al. 2018

Scandinavian Med Sci Sports

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“…Several authors evaluated the factors associated with return to sports activity. 8 9 The importance of psychological response and fear of reinjury (kinesophobia) after ACL-R has been also recently underlined. 10 11 12 Paterno et al, in their retrospective study on 40 ACL-Rs, concluded that patients with greater fear of reinjury were four times more likely to gain lower level of activity, seven times more likely to have a single-hop limb asymmetry, and six times more likely to have a deficit of quadriceps strength greater than 90% compared with the contralateral limb.…”

Section: Introductionmentioning

confidence: 99%

Factors Affecting Subjective and Objective Outcomes and Return to Play in Anterior Cruciate Ligament Reconstruction: A Retrospective Cohort Study

Rosso

Bonasia

Cottino

et al. 2018

Joints

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Purpose To analyze the prognostic factors influencing subjective and objective outcomes and return to play (RTP) after anterior cruciate ligament reconstruction (ACL-R). Methods Primary ACL-Rs using a transtibial technique performed between 2008 and 2012 were included. Data regarding patients, surgery, sports, and rehabilitation, including an on-field rehabilitation (OFR) and duration of the rehabilitation program, were collected. The International Knee Documentation Committee (IKDC) subjective and objective evaluation forms, and the Knee Injury and Osteoarthritis Outcome Score and Lysholm questionnaires were used for the assessment of subjective and objective outcomes. The Subjective Patient Outcome for Return to Sports and ACL–return to sport after injury (RSI) scores were used for RTP evaluation. Several potential predictors of outcome were tested with a univariate analysis. All the variables with p < 0.1 were retested in a logistic regression model to evaluate their association with the outcomes. Results In total, 176 cases were included with an average follow-up of 44.1 months. Of the patients, 92.2% were rated as normal or nearly normal at the IKDC evaluation. In addition, 90.1% of the patients returned to sport, with 57.6% returning to the same preinjury level. Objective outcomes were negatively influenced by late rehabilitation (odds ratio [OR] = 2.75). Performing an OFR phase during the rehabilitation was associated with better subjective outcomes (OR = 2.71). Length of rehabilitation strongly influenced the RTP rate (OR = 13.16). Conversely, higher ACL-RSI score was inversely related to RTP. Objective IKDC score was inversely related to the ACL-RSI (OR = 0.31), whereas subjective score was correlated with both the total ACL-RSI score (OR = 0.15) and the level of activity (OR = 0.20). Conclusion This study confirmed the role of rehabilitation on subjective and objective outcomes and on RTP. Particularly, the complete adherence to a rehabilitation program, including an OFR phase, resulted in better subjective outcomes and higher RTP rate. The relationship between psychological factors, measured through the ACL-RSI score, and RTP was confirmed. Level of Evidence Level III, observational study without a control group.

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“…Moreover, a highly challenging sport activity, which requires proper muscle control, may increase the risk of a new knee injury with repeat traumatic ACL rupture. [16][17][18][19] The time elapsed from surgery is often considered the most reliable criterion for granting the return to sporting gesture, and 6/7 months is considered a safe period by most surgeons. 5,8 Regarding professional players, coaches, agents, teammates, the player themselves, and family will often push the envelope on "cutting-edge surgical techniques" so that the player can return to sport as quickly as possible.…”

Section: Discussionmentioning

confidence: 99%

Return to Sport after ACL Surgery: A Comparison between Two Different Reconstructive Techniques

Baldassarri

Perazzo

Ghinelli³

et al. 2018

J Knee Surg

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The anterior cruciate ligament reconstruction (ACLR) has become a very common surgical procedure. One of the main success indicators of the surgical procedure is the return to preinjury sporting level. In recent years, reconstructive techniques have been geared toward less morbidity and optimized ligaments process to speed up the recovery of sports activity. This study compares clinical and imaging data, to evaluate the timing of return to sport, of two populations undergoing ACLR using two different techniques: ACLR with hamstring maintaining tibial insertion (MHG) and an all-inside technique with complete hamstring detachment (DHG). Patients were clinically evaluated with Marx rating scale, International Knee Documentation Committee (IKDC) score, and Tegner activity scale at a minimum follow-up (FU) of 4 years. The two groups have homogeneous characteristics: age, sex, type, and level of sports activity. Since November 2012, 59 patients with unilateral ACL insufficiency underwent ACLR: 31 patients using the MHG technique and 28 patients using the DHG technique. In both groups, a significant improvement in the clinical scores of the administered tests was observed. The MHG group reported a higher percentage of normal knees (83.8%) compared with the DHG group (78.6%). IKDC subjective score improved at each FU. Comparing the two techniques, at 12 months' FU the MHG group achieved better IKDC results (89.6) compared with the DHG technique (84.2). Marx and Tegner score values improved over time reaching comparable results at final FU. At final FU, 98% of patients returned to the same preinjury professional sporting level. Both techniques have been able to provide good clinical results. The MHG group, however, had a resumption of sports activity of the same level and intensity slightly longer (6.3 months) than that in the DHG group (5.9 months). Furthermore, the resumption of training and athletic gestures for the type of sport practiced was earlier than the DHG group. However, in the long run the level of sporting activity leveled in both groups, demonstrating the effectiveness of both techniques.

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Return to Sport-Specific Performance After Primary Anterior Cruciate Ligament Reconstruction: A Systematic Review

Abstract: CRD42016046709 (International Prospective Register of Systematic Reviews, https://www.crd.york.ac.uk/prospero/ ).

Cited by 68 publications

References 36 publications

Return to play, performance, and career duration after anterior cruciate ligament rupture: A case–control study in the five biggest football nations in Europe

Return to play, performance, and career duration after anterior cruciate ligament rupture: A case–control study in the five biggest football nations in Europe

Factors Affecting Subjective and Objective Outcomes and Return to Play in Anterior Cruciate Ligament Reconstruction: A Retrospective Cohort Study

Return to Sport after ACL Surgery: A Comparison between Two Different Reconstructive Techniques

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