Return to Sport after Anterior Cruciate Ligament Reconstruction: A Literature Review

P, Witvrouw E Kyritsis

doi:10.4172/2165-7025.1000193

Cited by 6 publications

(5 citation statements)

References 117 publications

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“…As these injuries remain a significant problem, research directed at rehabilitation is needed. An injured athlete is under pressure to return to competition as soon as possible and there is significant interest among sports medicine professionals in identifying an adequate indicator of safe return to activity [ 12 , 17 , 29 , 30 ]. Between 43 and 92 % of athletes return to their sports within 6–12 months following ACL reconstruction [ 14 ].…”

Section: Introductionmentioning

confidence: 99%

Functional assessments for decision-making regarding return to sports following ACL reconstruction. Part I: development of a new test battery

Hildebrandt

Müller

Zisch

et al. 2015

Knee Surg Sports Traumatol Arthrosc

111

155

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PurposeReturn to activity remains the most common concern following an injury. To facilitate the decision regarding a patient’s return to sport, we developed a standardized and easy-to-use test battery to enable an objective evaluation of knee function.MethodsThe test battery consisted of seven functional tests: the two-leg stability test, one-leg stability test (OL-ST), two-leg countermovement jump (CMJ), one-leg CMJ (OL-CMJ), plyometric jumps, speedy test and quick feet test. For each test, the reliability was determined based on the intraclass correlation coefficient. For all one-leg tests, the limb symmetry index (LSI) was calculated. ResultsAll tests showed a moderate-to-high reliability. Normative data from 434 participants were included in the analysis. The subjects were categorized according to age as follows: children (10–14 years), youth (15–19 years), young adults (20–29 years) and adults (30–50 years). The establishment of the functional test values allowed the classification into five normative categories. The LSI for the OL-ST (98 %) indicated a better performance of the non-dominant leg. In contrast, high LSI values were found for the OL-CMJ (124 %), indicating a better performance of the dominant leg.ConclusionEach test was found to be reliable and simple to perform. The better performance of the non-dominant leg in stability tasks must be considered when interpreting side-to-side differences. The established norm data from healthy individuals of each test battery represents an important basis for a clinical setting. Test results from an ACL-reconstructed patient should be at least classified as a functionally average outcome to support a safe return to sports.Level of evidenceIV.

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Section: Introductionmentioning

confidence: 99%

Functional assessments for decision-making regarding return to sports following ACL reconstruction. Part I: development of a new test battery

Hildebrandt

Müller

Zisch

et al. 2015

Knee Surg Sports Traumatol Arthrosc

111

155

View full text Add to dashboard Cite

show abstract

“…19 Nevertheless, important considerations for clinicians when preparing an athlete to return to sport are to ensure adequate graft healing, minimize the risk for subsequent injury, and prevent the development of osteoarthritis 19,60 ; and evidence-based rehabilitation guidelines are broadly structured around these considerations. 2,33 hoW many people return to sport after acl reconstruction?…”

Section: When Is It Safe To Return To Sport?mentioning

confidence: 99%

Anterior Cruciate Ligament Reconstruction—Not Exactly a One-Way Ticket Back to the Preinjury Level

Ardern

2015

Sports Health: A Multidisciplinary Approach

143

100

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Context:A recently updated meta-analysis of return-to-sport rates after anterior cruciate ligament (ACL) reconstruction demonstrated that 65% of athletes returned to their preinjury level of sport after surgery. The aim of this clinical review was to explore contextual factors associated with returning or not returning to the preinjury level after ACL reconstruction.Evidence Acquisition:Data were obtained from peer-reviewed literature via a search of the electronic databases Medline, Embase, CINAHL, and SPORTDiscus from database inception to January 2015. The keywords anterior cruciate ligament and return to sport were used. Additional literature was identified via hand-searching of the reference lists of relevant articles and the ePublication lists of key scientific journals. Random effects meta-analyses were used to pool the results of modifiable contextual factors and to examine their association with returning or not returning to the preinjury level of sport after surgery.Study Design:Clinical review.Level of Evidence:Level 2.Results:Lower fear of reinjury (standardized mean difference, 0.7), greater psychological readiness to return to sport (standardized mean difference, 1.0), and a more positive subjective assessment of knee function (standardized mean difference, 0.9) favored return to the preinjury level after surgery.Conclusion:Returning or not returning to the preinjury level after ACL reconstruction is complex and multifactorial. Screening for potentially modifiable contextual factors, particularly psychological factors, early after ACL injury may help clinicians identify athletes who could be at risk of not returning to the preinjury level of sport and institute interventions that could improve returning to sport.

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“…The preferred treatment strategy (surgery or not, in addition to physiotherapy), particularly with regards to the long-term outcomes is still under debate [21,22] and preferred treatment vary in different countries [1,23]. In either case, the rehabilitation programme is considered crucial for a successful return to sport [24]. Further, as of today it is well known that suffering an ACL injury also is likely to lead to psychological consequences such as loss of identity or fear of re-injury preventing participation in sports or other physical activities [25][26][27][28].…”

Section: Introductionmentioning

confidence: 99%

Retrospective experiences of individuals two decades after anterior cruciate ligament injury – a process of re-orientation towards acceptance

Fjellman‐Wiklund

Söderman

et al. 2021

Disability and Rehabilitation

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Purpose: Individual perspectives of long-term consequences decades after anterior cruciate ligament (ACL) injury are unexplored. We addressed experiences and the impact on life of former athletes >20 years post-ACL injury. Methods: Individual interviews, analysed using Grounded Theory, were conducted with 18 persons injured mainly during soccer 20-29 years ago. Results: A theoretical model was developed with the core category Re-orientation towards acceptance, overarching three categories illustrating the long-term process post-injury. Initially the persons felt like disaster had struck; their main recall was strong pain followed by reduced physical ability and fear of movement and re-injury. In the aftermaths of injury, no participant reached the pre-injury level of physical activity. Over the years, they struggled with difficult decisions, such as whether to partake or refrain from different physical activities, often ending-up being less physically active and thereby gaining body weight. Fear of pain and re-injury was however perceived mainly as psychological rather than resulting from physical limitations. Despite negative consequences and adjustments over the years, participants still found their present life situation manageable or even satisfying. Conclusion: ACL injury rehabilitation should support coping strategies e.g., also related to fear of reinjury and desirable physical activity levels, also with increasing age. ä IMPLICATIONS FOR REHABILITATIONMore than 20 years after the ACL injury, the individuals despite re-orientation towards acceptance and a settlement with their life situation, still had fear of both pain and re-injury of the knee, with concerns about physical activity and gaining of body weight. Patients with ACL injury may need better individual guidance and health advice on how to remain physically active, to find suitable exercises and to maintain a healthy body weight. Education related to pain, treatment choices, physical activity, injury mechanisms in participatory discussions with the patient about the ACL injury may be beneficial early in the rehabilitation process to avoid catastrophizing and avoidance behaviour. ACL injury rehabilitation needs to address coping strategies incorporating the psychological aspects of suffering an ACL injury, including fear of movement/secondary injury, in order to support returnto-sport and/or re-orientation over time.

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Return to Sport after Anterior Cruciate Ligament Reconstruction: A Literature Review

Cited by 6 publications

References 117 publications

Functional assessments for decision-making regarding return to sports following ACL reconstruction. Part I: development of a new test battery

Functional assessments for decision-making regarding return to sports following ACL reconstruction. Part I: development of a new test battery

Anterior Cruciate Ligament Reconstruction—Not Exactly a One-Way Ticket Back to the Preinjury Level

Retrospective experiences of individuals two decades after anterior cruciate ligament injury – a process of re-orientation towards acceptance

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