Sports Participation 2 Years After Anterior Cruciate Ligament Reconstruction in Athletes Who Had Not Returned to Sport at 1 Year

Ardern, Clare L; Taylor, Nicholas F.; Feller, Julian A.; Whitehead, Timothy S.; Webster, Kate E.

doi:10.1177/0363546514563282

Cited by 228 publications

(206 citation statements)

References 39 publications

Supporting

Mentioning

190

Contrasting

Order By: Relevance

“…A number of studies have found associations between return to sports and psychosocial/psychological variables (kinesiophobia/fear of reinjury, knee-related self-efficacy, confidence). 2,4,5,15,22,35,36 Further evaluation of the impact of these factors, along with that of strength, function, and performance, on return to sports is warranted. Third, only one criterion value (90%) was evaluated in this study, based on what is commonly regarded as acceptable for return-to-sport participation after ACL reconstruction.…”

Section: Discussionmentioning

confidence: 99%

Young Athletes Cleared for Sports Participation After Anterior Cruciate Ligament Reconstruction: How Many Actually Meet Recommended Return-to-Sport Criterion Cutoffs?

Toole

Ithurburn

Rauh

et al. 2017

Journal of Orthopaedic & Sports Physical Therapy

129

165

View full text Add to dashboard Cite

Rupture of the anterior cruciate ligament (ACL) is a devastating injury that occurs with high frequency among individuals who participate in cutting and pivoting sports. 24,48 Anterior cruciate ligament reconstruction is commonly performed with the goal of facilitating return to sports activities. However, recent metaanalysis data from over 7000 participants following ACL reconstruction demonstrated that 65% returned to their previous level of sport and only 55% returned to competitive sports.3 Factors associated with a higher rate of return to preinjury level of sport participation were younger age, male sex, positive psychological U U STUDY DESIGN: Prospective cohort study. U U BACKGROUND: While meeting objective criterion cutoffs is recommended prior to return to sports following anterior cruciate ligament (ACL) reconstruction, the number of young athletes who meet recommended cutoffs and the impact of cutoffs on longitudinal sports participation are unknown. U U OBJECTIVES:To test the hypothesis that a higher proportion of young athletes who meet recommended cutoffs will maintain the same level of sports participation over the year following return-to-sport clearance compared to those who do not meet recommended cutoffs. U U METHODS:At the time of return-to-sport clearance, the International Knee Documentation Committee Subjective Knee Evaluation Form (IKDC), quadriceps and hamstring strength limb symmetry index (LSI), and single-leg hop test LSI were assessed. Proportions of participants who met individual (IKDC score of 90 or greater; strength and hop test LSIs of 90% or greater) and combined cutoffs were calculated. Proportions of participants who continued at the same level of sports participation over the year following returnto-sport clearance (assessed using the Tegner activity scale) were compared between those who met and did not meet cutoffs. U U RESULTS:Participants included 115 young athletes (88 female). The proportions meeting individual cutoffs ranged from 43.5% to 78.3%. The proportions meeting cutoffs for all hop tests, all strength tests, and all combined measures were 53.0%, 27.8%, and 13.9%, respectively. A higher proportion of participants who met cutoffs for both strength tests maintained the same level of sports participation over the year following return-tosport clearance than those who did not (81.3% versus 60.2%, P = .02). U U CONCLUSION:The proportions of young athletes after ACL reconstruction recently cleared for return to sports who met the combined criterion cutoffs were low. Those who met the criterion cutoffs for both strength tests maintained the same level of sports participation at higher proportions than those who did not. U U LEVEL OF EVIDENCE: Prognosis, level 2b.

show abstract

Section: Discussionmentioning

confidence: 99%

Young Athletes Cleared for Sports Participation After Anterior Cruciate Ligament Reconstruction: How Many Actually Meet Recommended Return-to-Sport Criterion Cutoffs?

Toole

Ithurburn

Rauh

et al. 2017

Journal of Orthopaedic & Sports Physical Therapy

129

165

View full text Add to dashboard Cite

show abstract

“…Taken together, the discordance between patient satisfaction and returning to the pre-injury activity may suggest that imposing a generic definition of successful outcome may be difficult; that success is better defined by the individual. Recent studies have highlighted the potential impact of contextual factors (including social and lifestyle-related factors) on returning to the pre-injury sport, [32][33][34][35][36] and that many people do not return to their pre-injury sport following surgery. 32 People choose to participate or cease participating for many reasons that may have nothing to do with their knee.…”

Section: Discussionmentioning

confidence: 99%

Satisfaction With Knee Function After Primary Anterior Cruciate Ligament Reconstruction Is Associated With Self-Efficacy, Quality of Life, and Returning to the Preinjury Physical Activity

Ardern

Österberg

Sonesson

et al. 2016

Arthroscopy: The Journal of Arthroscopic & Related Surgery

Self Cite

View full text Add to dashboard Cite

Purpose: To assess whether patient-reported outcomes (psychological factors, appraisals of knee function, and physical activity participation) were associated with satisfaction with knee function after anterior cruciate ligament (ACL) reconstruction. Methods: Participants who were aged 18 to 45 years and a minimum 12 months post primary ACL reconstruction completed a questionnaire battery evaluating knee self-efficacy, knee-related quality of life, self-reported function, and physical activity participation. Participants responses to the question "If you were to spend the rest of your life with your knee just the way it has been in the last week, would you feel.... (7-point ordinal scale; 1 = happy, 7 = unhappy)" were categorized as satisfied, mostly satisfied, or dissatisfied and used as the primary outcome. Ordinal regression was used to examine associations between independent variables and the primary outcome. Results: A total of 177 participants were included at an average of 3 years after primary ACL reconstruction. At follow-up, 44% reported they would be satisfied, 28% mostly satisfied, and 28% dissatisfied with the outcome of ACL reconstruction. There were significant differences in psychological responses and appraisal of knee function between the 3 groups (P = .001), and significantly more people in the satisfied group had returned to their preinjury activity (58%) than in the mostly satisfied (28%) and dissatisfied (26%) groups (P = .001). Multivariable analysis demonstrated that the odds of being satisfied increased by a factor of 3 with higher self-efficacy, greater knee-related quality of life, and returning to the preinjury activity. Conclusions: People who had returned to their preinjury physical activity and who reported higher knee-related self-efficacy and quality of life were more likely to be satisfied with the outcome of ACL reconstruction

show abstract

“…When the level of sport participation was taken into account, only 65% returned to their preinjury level of sport and 55% returned to competitive sport, despite achieving successful surgical outcomes. [9][10][11][12][13] Readiness to return to sport after ACLR is commonly based on a multitude of functional measures, such as strength, power, and proprioception of the involved extremity. 4,6 Successful functional outcomes and satisfactory patient-reported outcomes are often the main criteria for clearance in returning an athlete to sport and the preinjury level of activity after ACLR.…”

mentioning

confidence: 99%

Decision to Return to Sport After Anterior Cruciate Ligament Reconstruction, Part I: A Qualitative Investigation of Psychosocial Factors

Burland

Toonstra

Werner

et al. 2018

Journal of Athletic Training

View full text Add to dashboard Cite

Context: Return-to-sport criteria after anterior cruciate ligament (ACL) injury are often based on “satisfactory” functional and patient-reported outcomes. However, an individual's decision to return to sport is likely multifactorial; psychological and physical readiness to return may not be synonymous. Objective: To determine the psychosocial factors that influence the decision to return to sport in athletes 1 year post–ACL reconstruction (ACLR). Design: Qualitative study. Setting: Academic medical center. Patients or Other Participants: Twelve participants (6 males, 6 females) were purposefully chosen from a large cohort. Participants were a minimum of 1-year postsurgery and had been active in competitive athletics preinjury. Data Collection and Analysis: Data were collected via semistructured interviews. Qualitative analysis using a descriptive phenomenologic process, horizontalization, was used to derive categories and themes that represented the data. The dynamic-biopsychosocial model was used as a theoretical framework to guide this study. Results: Six predominant themes emerged that described the participants' experiences after ACLR: (1) hesitation and lack of confidence led to self-limiting tendencies, (2) awareness was heightened after ACLR, (3) expectations and assumptions about the recovery process influenced the decision to return to sport after ACLR, (4) coming to terms with ACL injury led to a reprioritization, (5) athletic participation helped reinforce intrinsic personal characteristics, and (6) having a strong support system both in and out of rehabilitation was a key factor in building a patient's confidence. We placed themes into components of the dynamic-biopsychosocial model to better understand how they influenced the return to sport. Conclusions: After ACLR, the decision to return to sport was largely influenced by psychosocial factors. Factors including hesitancy, lack of confidence, and fear of reinjury are directly related to knee function and have the potential to be addressed in the rehabilitation setting. Other factors, such as changes in priorities or expectations, may be independent of physical function but remain relevant to the patient-clinician relationship and should be considered during postoperative rehabilitation.

show abstract

Sports Participation 2 Years After Anterior Cruciate Ligament Reconstruction in Athletes Who Had Not Returned to Sport at 1 Year

Cited by 228 publications

References 39 publications

Young Athletes Cleared for Sports Participation After Anterior Cruciate Ligament Reconstruction: How Many Actually Meet Recommended Return-to-Sport Criterion Cutoffs?

Young Athletes Cleared for Sports Participation After Anterior Cruciate Ligament Reconstruction: How Many Actually Meet Recommended Return-to-Sport Criterion Cutoffs?

Satisfaction With Knee Function After Primary Anterior Cruciate Ligament Reconstruction Is Associated With Self-Efficacy, Quality of Life, and Returning to the Preinjury Physical Activity

Decision to Return to Sport After Anterior Cruciate Ligament Reconstruction, Part I: A Qualitative Investigation of Psychosocial Factors

Contact Info

Product

Resources

About