Low rates of patients meeting return to sport criteria 9 months after anterior cruciate ligament reconstruction: a prospective longitudinal study

• Published in: Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA Vol. 26; no. 12; pp. 3636 - 3644
• Main Authors: Welling, Wouter, Benjaminse, Anne, Seil, Romain, Lemmink, Koen, Zaffagnini, Stefano, Gokeler, Alli
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.12.2018; John Wiley & Sons, Inc
• Subjects: Adolescent; Anterior cruciate ligament; Anterior Cruciate Ligament Reconstruction; Correlation analysis; Criteria; Exercise Test; Female; Hop tests; Humans; Isokinetic strength; Knee; Landing; Leg; Longitudinal Studies; Male; Medicine; Medicine & Public Health; Movement analysis; Muscle Strength; Orthopedics; Patients; Prospective Studies; Quadriceps muscle; Recovery of function; Rehabilitation; Return to Sport; Skin & tissue grafts; Strength; Young Adult; Movement analysis; Hop tests; Return to sport; Anterior cruciate ligament; Strength
• ISSN: 0942-2056; 1433-7347; 1433-7347
• DOI: 10.1007/s00167-018-4916-4

Purpose The purpose of the current prospective study was to assess the changes over time in patients tested at 6 months and 9 months after anterior cruciate ligament reconstruction (ACLR) with a return to sport (RTS) test battery. It was hypothesized that more patients passed RTS criteria at 9 months compared to 6 months. Methods Sixty-two ACLR patients performed a test battery at an average of 6.5 ± 0.7 and 9.5 ± 0.9 months after ACLR. All patients underwent a standardized rehabilitation protocol. The test battery consisted of the following tests: a jump-landing task assessed with the Landing Error Scoring System (LESS), three single-leg hop tasks (single-leg hop test, triple-leg hop test, side hop test), isokinetic quadriceps and hamstring strength at 60, 180 and 300°/s and two questionnaires (IKDC and ACL–RSI). Cut off criteria were set as Limb Symmetry Index (LSI) > 90% (for isokinetic strength and for single-leg hop tasks), LESS < 5, IKDC score within 15th percentage of healthy subjects and ACL–RSI > 56 respectively. Results At 6 months, two patients (3.2%) passed all criteria. At 9 months, seven patients (11.3%) passed all criteria. Patients improved in all RTS criteria over time except for the IKDC score. Twenty-nine patients (46.8%) did not pass the strength criterion at 60°/s at 9 months after ACLR. Conclusions The percentages of patients passing all RTS criteria were low at both 6 and 9 months after ACLR. Quadriceps strength revealed persistent deficits and the lack of improvement in the IKDC score questionnaires shows insufficient self-reported knee function for RTS. Level of evidence III.