Patient expectations and perceived social support related to return to sport after anterior cruciate ligament reconstruction in adolescent athletes

Armento, Aubrey; Albright, Jay C.; Gagliardi, Alexia G.; Daoud, Ariel Kiyomi; Howell, David R.; Mayer, Stephanie W.

doi:10.1016/j.ptsp.2020.10.011

Cited by 15 publications

(11 citation statements)

References 41 publications

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“…Although these differences resolved by 12 months, these findings are clearly important because many patients expect to return to sport well before 12 months postoperatively. 12 Consequently, there is an important need to evaluate whether anterolateral ligament reconstruction (ALLR) and other types of LEAPs are also associated with delayed functional recovery when compared with isolated ACLR.…”

mentioning

confidence: 99%

Anterolateral Ligament Reconstruction Does Not Delay Functional Recovery, Rehabilitation, and Return to Sport After Anterior Cruciate Ligament Reconstruction: A Matched-Pair Analysis From the SANTI (Scientific ACL Network International) Study Group

Coquard

Carrozzo

Saithna

et al. 2022

Arthroscopy, Sports Medicine, and Rehabilitation

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Purpose To determine whether the addition of an anterolateral ligament reconstruction (ALLR) resulted in delayed functional recovery (based on the Knee Santy Athletic Return to Sport [K-STARTS] score) at 6 months after anterior cruciate ligament reconstruction (ACLR). Methods A retrospective analysis of prospectively collected data from consecutive patients who underwent an ACLR between September 2017 and December 2020 was conducted. Patients who received an isolated hamstring autograft (isolated ACLR group) were propensity matched in a 1:1 ratio to patients who received a hamstring autograft ACLR combined with an ALLR (ACLR-ALLR group). Outcome measures included the Tegner Activity Scale and the K-STARTS test—a validated composite return-to-sports test (including the Anterior Cruciate Ligament–Return to Sport After Injury scale, Qualitative Assessment of Single-Leg Landing tool, limb symmetry index, and ability to change direction using the Modified Illinois Change of Direction Test). Results The study included 111 matched pairs. At 6 months postoperatively, there were no significant differences between groups in the overall K-STARTS score (65.4 for isolated ACLR vs 61.2 for ACLR-ALLR, P = .087) or the Tegner Activity Scale score (3.7 for isolated ACLR vs 3.8 for ACLR-ALLR, P = .45). In addition, an evaluation of the subscales of the K-STARTS score revealed no disadvantage across the domains of neuromuscular control, limb symmetry index, agility, or psychological readiness to return to sport when an ALLR was performed. Conclusions The addition of ALLR at the time of ACLR does not delay functional recovery. Specifically, at 6 months postoperatively, there was no disadvantage in patients undergoing ALLR-ACLR, when compared with those undergoing isolated ACLR, with respect to neuromuscular control, limb symmetry indices (hop tests), agility, or psychological readiness to return to sport. Level of Evidence Level III, retrospective comparative study.

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mentioning

confidence: 99%

Anterolateral Ligament Reconstruction Does Not Delay Functional Recovery, Rehabilitation, and Return to Sport After Anterior Cruciate Ligament Reconstruction: A Matched-Pair Analysis From the SANTI (Scientific ACL Network International) Study Group

Coquard

Carrozzo

Saithna

et al. 2022

Arthroscopy, Sports Medicine, and Rehabilitation

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“…Moreover, individuals who are in secondary school engage in different types of PA when compared with older individuals no longer in secondary school. 5 , 42 While our study is the first to directly compare PA among these age groups, future investigations should focus on developing greater understanding regarding the underlying cause of PA participation limitations, in addition to quantifying PA among this patient population. Lastly, the distribution of sexes was significantly different between our groups, which may have influenced our findings.…”

Section: Discussionmentioning

confidence: 99%

Adolescents Are Less Physically Active Than Adults After Anterior Cruciate Ligament Reconstruction

Kuenze

Collins

Triplett

et al. 2022

Orthopaedic Journal of Sports Medicine

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Background: Sources of physical activity (PA) and motivation for return to sport after anterior cruciate ligament reconstruction (ACLR) differ between adolescents and adults. It is unclear whether these differences influence participation in PA during the first year after ACLR when individuals are transitioning from rehabilitative care to unrestricted activity. Purpose: To compare device-assessed measures of PA between adolescents and adults at 6 to 12 months after ACLR. Study Design: Cross-sectional study; Level of evidence, 3. Methods: Included were 22 adolescents (age, 15.9 ± 1.2 years; time since surgery = 8.0 ± 2.1 months) and 23 adults (age, 22.5 ± 5.0 years; time since surgery = 8.2 ± 2.1 months) who were cleared for unrestricted PA after primary unilateral ACLR. Participants were considered physically active if they met their age-specific United States Department of Health and Human Services PA guidelines. Participants wore an accelerometer-based PA monitor for at least 7 days. Daily minutes of moderate to vigorous–PA (MVPA) and daily step counts were reported and compared between age groups using analysis of covariance, with monitor wear time and sex included as covariates. The association between age group and meeting age-specific PA guidelines was assessed using binary logistic regression and reported as an odds ratio. Results: Adults with ACLR participated in 16 minutes more MVPA per day (49 ± 22 vs 33 ± 16 minutes per day; P < .001) and took 2212 more steps per day (8365 ± 2294 vs 6153 ± 1765 steps per day; P < .001) when compared with adolescent participants. In addition, 83% of adults were physically active, compared with 9% of adolescents (odds ratio = 60.2; 95% CI, 7.6-493.4). Conclusion: Adolescents with ACLR were less physically active than adults with ACLR, and only 9% of adolescents met aerobic PA guidelines. This is concerning because PA patterns adopted early in life are predictive of PA patterns in adulthood. Our findings indicate a need to better understand underlying causes of reduced PA among adolescents with ACLR and to develop intervention strategies that promote engagement in adequate PA after rehabilitation.

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“…Many young athletes expect to RTS much sooner than the expected timeline. 127 There are considerable differences in the literature regarding time to RTS in this population, and the appropriate time to return to play is currently unknown. Earlier RTS has been shown to be predictive of a second ACL injury in youth athletes.…”

Section: Time To Return To Sport Is Later In Youth Athletesmentioning

confidence: 99%

Unique Considerations for the Pediatric Athlete During Rehabilitation and Return to Sport After Anterior Cruciate Ligament Reconstruction

Matsuzaki

Chipman

Perea

et al. 2022

Arthroscopy, Sports Medicine, and Rehabilitation

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Anterior cruciate ligament (ACL) injuries and surgical intervention in the pediatric population have increased in the recent years. Although surgical techniques have advanced, evidence-based rehabilitation guidelines that consider all aspects of the youth athlete are currently lacking. The purpose of this commentary is to review the current evidence on unique considerations for the pediatric and adolescent population during rehabilitation and return to sport after ACL reconstruction (ACLR), with a focus on children under 18 years of age. This review revealed that returning a youth athlete to sport after ACLR requires knowledge and appreciation of various aspects of the growing athlete different from adults. In addition to postoperative precautions that contribute to a slow rehabilitation process, young athletes need additional time for strength gains. Address risk of reinjury and for contralateral injury by using neuromuscular training and rigorous return-to-sport training programs. Consider return to sport after 9 months because the reinjury rate is high in this population. A combination of time and objective measures, both quantitative and qualitative criteria, and psychological readiness should be used to assess readiness to return to sport and decrease risk of future injury. Healthcare providers should be aware of the psychosocial impact of injury on the youth athletes and refer to sport psychology when necessary. Level of Evidence: Level V.O ver the last 2 decades, anterior cruciate ligament (ACL) injuries and surgical intervention in children and adolescents have been increasing. [1][2][3][4][5][6][7] This increase is often attributed to increased participation in competitive organized sports, 8 early sports specialization, 9 and year-round training and competition. 10 Furthermore, advancements in surgical techniques allow for early reconstruction of the ACL in the

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Patient expectations and perceived social support related to return to sport after anterior cruciate ligament reconstruction in adolescent athletes

Cited by 15 publications

References 41 publications

Anterolateral Ligament Reconstruction Does Not Delay Functional Recovery, Rehabilitation, and Return to Sport After Anterior Cruciate Ligament Reconstruction: A Matched-Pair Analysis From the SANTI (Scientific ACL Network International) Study Group

Anterolateral Ligament Reconstruction Does Not Delay Functional Recovery, Rehabilitation, and Return to Sport After Anterior Cruciate Ligament Reconstruction: A Matched-Pair Analysis From the SANTI (Scientific ACL Network International) Study Group

Adolescents Are Less Physically Active Than Adults After Anterior Cruciate Ligament Reconstruction

Unique Considerations for the Pediatric Athlete During Rehabilitation and Return to Sport After Anterior Cruciate Ligament Reconstruction

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