LOW RATES OF PATIENTS MEETING RETURN TO SPORT CRITERIA 9 MONTHS AFTER ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION: A PROSPECTIVE LONGITUDINAL STUDY

Review written by Scot Morisson info

BACKGROUND & OBJECTIVE

A significant and growing body of data exists to indicate that testing physical and psychological abilities is necessary for making return to play decisions. A time frame of 6 months following ACL reconstruction has been used traditionally, but this has been challenged by data showing longer time frames result in better outcomes on testing and injury risk. The authors in this study looked at performance on a return to play test battery at 6 and 9-month intervals in order to determine if there was a significant difference in results.

METHODS

ACLR patients were recruited by a single researcher from a rehabilitation facility with data collected between 2015 and 2017. Initially 81 patients met the inclusion criteria but only 61 were included after attrition was accounted for. Patients were taken through the test battery twice; both at 6.5 ± 0.7 and 9.5 ± 0.9 months after ACLR. The battery included tests for knee flexion and extension strength (Isokinetic at 60/120/300o/s), jumping (triple hop, side hop, and single leg hop tests), landing task assessment (Landing Error Scoring System) and outcome scores (International Knee Documentation Committee Subjective Knee Form (IKDC) and the Anterior Cruciate Ligament–Return to Sport after Injury Scale (ACL– RSI)). A 2x2 ANOVA was used to compare 6 and 9 months, involved and uninvolved legs, and hamstring and patellar tendon grafts. A power analysis indicated a need for a sample of 27 with an effect size of 0.50 and alpha of 0.05 in order to achieve a power of 0.80. In addition they also performed a regression analysis looking at the ability of the individual tests to predict passing the test battery.

RESULTS

Of the 62 patients included only 2 (3.2%) passed all tests at 6 months and that only increased to 11 (11.3%) by the 9-month mark. For the strength tests only 5 (8.1%) passed at 6 months and 13 (21%) patient

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