Return to Work After Anterior Cruciate Ligament Reconstruction: A Systematic Review

• Published in: Orthopaedic journal of sports medicine Vol. 12; no. 5; p. 23259671241249086
• Main Authors: Özbek, Emre Anıl, Dursun Savran, Merve, Baltacı, Çağatay, Herman, Zachary J., Zsidai, Bálint, Wailing, Jacon, Samuelsson, Kristian, Musahl, Volker
• Format: Book Review Journal Article
• Language: English
• Published: Los Angeles, CA SAGE Publications 01.05.2024; Sage Publications Ltd
• Subjects: ACL; ACL reconstruction; allograft; autograft; graft; Ligaments; Orthopedics; Ortopedi; return to work; Review; Systematic review; autograft; ACL reconstruction; ACL; graft; return to work; allograft
• ISSN: 2325-9671; 2325-9671
• DOI: 10.1177/23259671241249086

Background: The timing of return to work (RTW) after anterior cruciate ligament (ACL) reconstruction (ACLR) is a less studied milestone compared with return to sports. Purpose: To systematically review the rate and postoperative timing of RTW after ACLR. Study Design: Systematic review; Level of evidence, 4. Methods: This study was conducted in accordance with the 2020 PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement. A literature search was performed in PubMed, Embase, Cochrane, and Ovid databases for clinical studies reporting RTW after ACLR, and 806 studies were identified in August 2022. A quality assessment was performed using the Methodological Index of Nonrandomized Studies (MINORS) grading system. The following data were extracted from studies: study characteristics, cohort demographics, ACLR technique, concomitant meniscal and/or cartilage procedures, preoperative patient-reported outcomes, rates of RTW, and days required for RTW after ACLR. Results: A total of 13 studies met inclusion criteria, totaling 1791 patients (86.4% male). Wide variability was observed in the methodological quality of the assessed studies (MINORS score range, 8-17). Hamstring tendon (HT) autograft was used in 76.8% (n = 1377; mean age, 30.5 years old), allograft in 17.1% (n = 308; mean age, 33.1 years old), the ligament advanced reinforcement system in 2.5% (n = 46; mean age, 33.2 years old), bone-patellar tendon-bone autograft in 2% (n = 36; mean age, 28.5 years old), and quadriceps tendon autograft in 1.3% (n = 24; mean age, 24.1 years old). Among the included patients, 99.1% (n = 1781) reported successful RTW after surgery. The mean time to RTW was 84.2 days (range, 31.4-107.1 days) for HT and 69.5 days (range, 49-56.6 days) for allograft. Conclusion: While data regarding work intensity before and after ACL injury were absent, our study results suggested that patients most often RTW within 90 days of surgery. Patients with allograft ACLR may RTW earlier than patients undergoing ACLR with HT autograft.