Returning to Sport After Anterior Cruciate Ligament Reconstruction in Physically Active Individuals

Alswat, Muath M; Khojah, Osama; Alswat, Anas; Alghamdi, Abdulrhman; Almadani, Mohab; Alshibely, Ammar; Dabroom, Albara A.; Algarni, Hussam M; Alshehri, Mohammed

doi:10.7759/cureus.10466

Cited by 9 publications

(9 citation statements)

References 28 publications

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“…Every patient must be evaluated frequently and return gradually to his previous activities. A recent cross-sectional study demonstrated a low rate of returning to sports after ACL reconstruction, with psychological aspects playing a significant role and fear of reinjury being the most frequent cause of not returning to sport [ 6 ]. A systematic review and meta-analysis by Ardern et al [ 30 ] showed that on average, 81% of people returned to any sport, 65% returned to their pre-injury level of sport and 55% returned to the competitive level sport after surgery.…”

Section: Discussionmentioning

confidence: 99%

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Comparison of Bone-Patella Tendon-Bone and Four-Strand Hamstring Tendon Grafts for Anterior Cruciate Ligament Reconstruction: A Prospective Study

Arida¹,

Tsikrikas²,

Mastrokalos³

et al. 2021

Cureus

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Introduction To date, the proper choice of graft for anterior cruciate ligament (ACL) reconstruction remains a matter of conflict. We aimed to compare the clinical and functional outcomes of the two most commonly utilized autografts, bone-patella tendon-bone (BPTB) and four-strand hamstring tendon (HT) graft, at 6 and 12 months after surgery. Methods In a prospective randomized study, we included a total of 60 patients undergoing ACL reconstruction, thirty in BPTB and thirty in HT group. All patients were amateur athletes and were evaluated at 6 and12 months after surgery for: (a)postoperativefunctionality of the operated knee by the Tegner, the Lysholm and the International Knee Documentation Committee (IKDC) scoring scales, (b) anterior cruciate ligament (ACL) instability of the operated knee compared to the healthy contralateral knee by the KT-1000 arthrometer and (c) theextension and flexion muscle strength of the operated knee by a CYBEXisokinetic dynamometer. Results Patients in the two groups did not differ regarding demographics, and pre-injury functionality status. Significantly more patients in the HT group (n=6) compared to the BPTB group (n=1) experienced ACL re-rupture and underwent revision surgery before follow-up end (p=0.044). All patients, regardless of graft, showed significant improvement within each group of functional assessments by Lysholm, Tegner and IKDC scores, as well as of Cybex measurements -with an increase of peak torque at 60° extension and 180°extension and 60° flexion and 180° flexion- at 12 months compared to 6 months follow-up (p<0.05). However, there was no difference between the two groups regarding knee function improvement or extension measurements neither at 6 nor 12 months. Contrarily, the BPTB graft group had higher values of peak torque (Nm) at 60° and 180° flexion compared to the HT group, both at 6 (p=0.014 and 0.029, respectively) and 12 months (p=0.033 and 0.030, respectively). Postoperative stability was similar between the two groups at 12 months (p=0.519). Conclusion Both BPTB and HT grafts present with benefits and drawbacks and remain viable autograft options for primary ACL reconstruction as each has, although HT grafts seem to be more susceptible to re-rupture. The graft selection should be based on the needs and activities of each patient.

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Section: Discussionmentioning

confidence: 99%

“…The primary goal of surgery is to achieve a functionally stable knee while minimizing morbidity and complications associated with the procedure. The autograft of bone-patella tendon-bone (BPTB) and the autograft of four-strand hamstring tendon, are the most commonly used ones on ACL reconstruction around the world [4][5][6].…”

Section: Introductionmentioning

confidence: 99%

Comparison of Bone-Patella Tendon-Bone and Four-Strand Hamstring Tendon Grafts for Anterior Cruciate Ligament Reconstruction: A Prospective Study

Arida¹,

Tsikrikas²,

Mastrokalos³

et al. 2021

Cureus

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“…Following ACLR, the goal of surgery and rehabilitation is to return the patient to their preinjury functional levels [14][15]. To evaluate the effectiveness of surgical and rehabilitation outcomes, tools capable of assessing patient reported outcome in a reliable and valid fashion are necessary [16][17][18].…”

Section: Mean ± Sd Rangementioning

confidence: 99%

Assessment of the Global Rating of Knee Function in Patients Following Anterior Cruciate Ligament Reconstruction

Ross

Prall

2022

Phys Ther Rehabil Sci

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According to the International Classification of Functioning, Disability and Health, participation refers to involvement in life situations and participation restrictions refer to problems an individual may experience with involvement in life situations [1]. When evaluating patients with a history of anterior cruciate ligament reconstruction (ACLR), it is common for clinicians to determine the patient's level of participation restriction [2]. This is usually done by assessing patient perceived levels of function during activities of daily living or sporting activities through patient self-report measures, such as the Knee Outcome Survey (KOS) [3], the Cincinnati Knee Scoring System [4], the International Knee Documentation Committee Subjective Knee Form [5], or the Lysholm Knee Scale [6].In addition to assessing patient perceived levels of knee function through a patient self-report measure, several authors have also assessed patient perceived levels of knee function with a global rating of knee function by asking patients to rate their level of knee function on a scale of 0 to 100, with 0 points representing complete loss of function due to their knee injury and 100 points representing their level of function prior to their knee injury. Worrell et al [7] used the Functional Limitations with Activities of Daily Living Scale, a modified component of the KOS, and the global rating of knee function to

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“…Meanwhile, physical conditions such as persistent knee symptoms such as pain, swelling, stiffness, instability, and weakness also cause individuals not to return to their sport. 25 Based on the data collection and analysis results, there were indications of variability in the participants' postreconstruction duration. The average post-ACL reconstruction duration was 10.9 ± 5.9 months with a variance of 35.2, a maximum of 24 months, and a minimum of 3 months, so the range was 21 months.…”

Section: Original Articlementioning

confidence: 99%

“…Knee physical function can affect the psychological response, so if the individual has stable and good knee function, the psychological response experienced is also the same and vice versa. 25,26 This can cause a strong correlation of the ACL-RSI score with each subscale KOOS.…”

Section: Original Articlementioning

confidence: 99%

Indonesian Version of the Anterior Cruciate Ligament-Return to Sport After Injury Questionnaire Through Cross-Cultural Adaptation, Validity, and Reliability Testing

Ihsan

Wibawa

Muliarta

et al. 2022

ptji

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Background: This study aimed to produce the Indonesian version of the Anterior Cruciate Ligament-Return to Sport After Injury (ACL-RSI) questionnaire and determine the value of content validity, construct validity, known-groups validity, and internal consistency reliability. Methods: First, the ACL-RSI questionnaire was translated through a cross-cultural adaptation process. Six experts in related fields assessed the adapted questionnaire by giving scores on four criteria: relevance, clarity, simplicity, and ambiguity, which will be calculated into content validity value. Seventy-one participants who experienced ACL injury because of sporting activities and had undergone reconstruction who joined the online community for Knee Injury Patients Support Group filled out the ACL-RSI to determine the known-groups validity and internal consistency reliability. The participants also filled out the Indonesian version of the Knee Injury and Osteoarthritis Outcome Score (KOOS) as a comparison to test construct validity. Results: The calculated content validity value obtained from the experts’ scoring was S-CVI/Ave = 0.97. Construct validity between ACL-RSI and all KOOS subscales showed a strong positive correlation with r = 0.78-0.87. Two hypotheses for known-groups validity were proven, with the group that had returned to their specific sport having a better ACL-RSI score than the group that had not returned (70.2 ± 10.0 vs. 49.3 ± 18.8, p<0.001), and the group planned to return to their specific sport as before the injury had a better ACL-RSI score than the group who did not intend to return (60.3 ± 16.5 vs. 32.6 ± 2.4, p<0.001). Internal consistency ACL-RSI showed very good reliability with Cronbach’s alpha = 0.96. Conclusions: The Indonesian version of ACL-RSI is valid and reliable for evaluating psychological readiness to return to sports after ACL reconstruction. However, a seemingly further similar study is necessary to fix the weaknesses in this study to produce a more representative Indonesian version of the ACL-RSI questionnaire.

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Returning to Sport After Anterior Cruciate Ligament Reconstruction in Physically Active Individuals

Cited by 9 publications

References 28 publications

Comparison of Bone-Patella Tendon-Bone and Four-Strand Hamstring Tendon Grafts for Anterior Cruciate Ligament Reconstruction: A Prospective Study

Comparison of Bone-Patella Tendon-Bone and Four-Strand Hamstring Tendon Grafts for Anterior Cruciate Ligament Reconstruction: A Prospective Study

Assessment of the Global Rating of Knee Function in Patients Following Anterior Cruciate Ligament Reconstruction

Indonesian Version of the Anterior Cruciate Ligament-Return to Sport After Injury Questionnaire Through Cross-Cultural Adaptation, Validity, and Reliability Testing

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