Measuring Physical Activity and Sports Participation After Autologous Cartilage Implantation: A Systematic Review

Abstract

Context:The assessment of physical activity and return to sport and exercise activities is an important component in the overall evaluation of outcome after autologous cartilage implantation (ACI). Objective: To identify the patient-report instruments that are commonly used in the evaluation of physical activity and return to sport after ACI and provide a critical analysis of these instruments from a rehabilitative perspective. Evidence Acquisition: A computerized search was performed in January 2013 and repeated in March 2013. Criteria for inclusion required that studies (1) be written in English and published between 1994 and 2013; (2) be clinical studies where knee ACI cartilage repair was the primary treatment, or comparison studies between ACI and other techniques or between different ACI generations; (3) report postoperative physical activity and sport participation outcomes results, and (4) have evidence level of I-III. Evidence Synthesis: Twenty-six studies fulfilled the inclusion criteria. Three physical activity scales were identified: the Tegner Activity Scale, Modified Baecke Questionnaire, and Activity Rating Scale. Five knee-specific instruments were identified: the Lysholm Knee Function Scale, International Knee Documentation Committee Score Subjective Form, Knee Injury and Osteoarthritis Outcome Score, Modified Cincinnati Knee Score, and Stanmore-Bentley Functional Score. Conclusions: Considerable heterogeneity exists in the reporting of physical activity and sports participation after ACI. Current instruments do not fulfill the rehabilitative needs in the evaluation of physical activity and sports participation. The validated instruments fail in the assessment of frequency, intensity, and duration of sports participation.

Sporting Activity Is Reduced 11 Years After First-Generation Autologous Chondrocyte Implantation in the Knee Joint

“…The validated instruments fail in the assessment of frequency, intensity, and duration of sports participation. 48 We therefore asked patients specifically about their sporting routines including the abovementioned factors of sporting activity. In our study, we found that 82.9% of the patients still played sports regularly at follow-up.…”

Return to Sports Activity and Work After Autologous Chondrocyte Implantation of the Knee

“…In today’s literature, several studies can be found that analyze return-to-sports rates in ACI patients. 8,17,30 Return to work after ACI, however, appears to be of much less interest. Specific data describing duration of absence from work after ACI, ability to perform work at the same level as preoperatively, or simply grade of satisfaction at patients’ workplace after ACI are currently elusive.…”

“…Previous studies presented patients’ general return-to-sport rates. 17,30 Detailed information regarding individual sporting activities, together with frequency and intensity of sports after ACI, is not yet found in today’s literature. We believe that this information is both relevant for the active ACI population as well as for the treating physician.…”

Returning to Work After Articular Cartilage Repair Intervention: A Systematic Review

“…Only 3 studies reported data on return to work after ACI 1,17,24 in the general population in contrast to the relatively large number of studies on return to sports after ACI. 19,28 The present review found that the surgical techniques of first-and second-generation ACI provide similar results in return to work. Return to work after surgical intervention with ACI is faster than return to sport (3.34 ± 2.75 vs 18 ± 4 months, respectively).…”