The Prognosis and Predictors of Sports Function and Activity at Minimum 6 Years After Anterior Cruciate Ligament Reconstruction: A Population Cohort Study (original) (raw)
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Arthroscopy: The Journal of Arthroscopic & Related Surgery, 2006
Patient outcomes at a minimum of 5 years after medial meniscus transplantation and primary anterior cruciate ligament (ACL) reconstruction via allograft tissues were compared with those of age-, sex-, and activity level-matched patients who underwent meniscal repair or partial meniscectomy and primary ACL reconstruction via allograft tissues. Methods: Eight patients (mean age, 51 Ϯ 5 years; three women and five men) at 5.5 Ϯ 0.5 years after medial meniscus transplantation and ACL reconstruction (group 1) and eight matched patients (mean age, 50 Ϯ 5 years; three women and five men) at 5.1 Ϯ 0.5 years after meniscal repair or partial meniscectomy and ACL reconstruction (group 2) completed the meniscus allograft clinical registry questionnaire, which combined the modified Lysholm knee scoring scale, the 1999 International Knee Documentation Committee subjective knee evaluation, and the knee pain level score on a 10-cm visual analog scale. Results: Both groups displayed similar improvements in the modified Lysholm knee scoring scale components of pain, knee stability, squatting, stair climbing, and limping, as well as overall score (P Ͻ .05). Only group 2 displayed significant reductions in swelling. The groups displayed similar improvements in the 1999 International Knee Documentation Committee subjective knee evaluation components of sitting, rising from a chair, running, jumping, and stopping quickly, as well as overall score (P Ͻ .05). They also displayed significant improvements in the visual analog scale knee pain level score; however, group 1, which displayed greater preoperative pain levels, had considerably larger reductions. Most group 1 patients (7/8 [87.5%]) and all group 2 patients (8/8 [100%]) considered their surgery to be a success and would undergo the same procedure again if necessary. Conclusions: Although group 1 had greater preoperative knee pain levels, their pain levels at 5 years postoperatively were comparable to those in group 2. With the exception of swelling, comparable improvements were observed between groups for all other variables. Level of Evidence: Level III, retrospective, case-control study.
Physical Therapy Rehabilitation Science, 2022
The purpose of this study was to assess the validity of the global rating of knee function as a measure of participation restrictions experienced during activities of daily living and sports by patients with a history of anterior cruciate ligament reconstruction (ACLR). Design: Cross-sectional study. Methods: Forty-three subjects (33 males, 10 females, age＝20.3 ± 1.3 years), at a mean of 31.2 ± 14.4 months following ACLR, participated in this study. During testing, subjects were first asked to provide a global rating of function by assessing their level of knee function on a 0 to 100 scale, with 0 points representing complete loss of function due to their knee injury and 100 points representing their level of function prior to their knee injury. After providing a global rating of function, subjects completed the Knee Outcome Survey (KOS) Activities of Daily Living Scale (ADLS) and Sports Activity Scale (SAS), which served as the measure of participation restrictions in this study. Results: Pearson product correlations revealed moderate relationships between the global rating of function and the ADLS (r＝ 0.66, p＜0.0001) and SAS (r＝0.69, p＜0.0001). Conclusions: The global rating of knee function provides a valid measure of participation restrictions experienced during activities of daily living and sports by patients with a history of ACLR.
Physical Therapy Research
Anterior cruciate ligament reconstruction (ACLR) is the standard surgical treatment for ACL injury, which typically uses a graft to replace the torn ligament in the knee that uses small incisions with minimally invasive surgery. The optimal knee functions following ACLR depend on rehabilitation processes before and after the surgery. Knee function is the ability of the knee to perform various types of functional movements like walking, squatting, running, jumping, and pivoting where patients expect to achieve maximum knee function or at least more than 80% of its initial condition before the injury to avoid being categorized as poor knee function after ACLR. Patients use patient-reported outcome measures to collect data on their health status and quality of life after ACLR. Post-traumatic osteoarthritis (PTOA) is a type of OA that manifests in local cartilage injury caused by chondrocyte death, and matrix dispersion occurs following a joint injury like ACL injury. Gender, time from injury to surgery, and graft type were considered as risk factors for poor knee function after ACLR, while overweight, meniscus tear, and cartilage defect as risk factors for PTOA. However, age is an internal risk factor for both poor knee function and PTOA following ACLR. This review suggests several strategies to prevent both conditions, including a pre-operative program, comprehensive rehabilitation, body weight control, and return to sport (RTS) consideration based on physical capacity, proper time, and psychological readiness.
Clinical Orthopaedics and Related Research®, 2017
Background Athletes often are cleared to return to activities 6 months after anterior cruciate ligament (ACL) reconstruction; however, knee function measures continue to improve up to 2 years after surgery. Interventions beyond standard care may facilitate successful return to preinjury activities and improve functional outcomes. Perturbation training has been used in nonoperative ACL injury and preoperative ACL reconstruction rehabilitation, but has not been examined in postoperative ACL reconstruction rehabilitation, specifically return to sport rehabilitation. Questions/Purposes The purpose of this study was to determine whether there were differences at 1 and 2 years after ACL reconstruction between the male SAP (strengthening, agility, and secondary prevention) and SAP+PERT (SAP protocol with the addition of perturbation training) groups with respect to (1) quadriceps strength and single-legged hop limb symmetry; (2) patient-reported knee outcome scores; (3) the proportion who achieve selfreported normal knee function; and (4) the time from surgery to passing return to sport criteria. Methods Forty men who had completed ACL reconstruction rehabilitation and met enrollment criteria (3-9 months after ACL reconstruction, [ 80% quadriceps strength limb symmetry, no pain, full ROM, minimal effusion) were randomized into the SAP or SAP+PERT groups of the Anterior Cruciate Ligament-Specialised Post-Operative Return to Sports trial (ACL-SPORTS), a single-blind randomized clinical study of secondary prevention and return to sport. Quadriceps strength, singlelegged hopping, the International Knee Documentation Committee (IKDC) 2000 subjective knee form, Knee Injury and Osteoarthritis Outcome Score (KOOS)-sports and recreation, and KOOS-quality-of-life subscales were collected 1 and 2 years after surgery by investigators
Prediction of improvement after anterior cruciate ligament reconstruction
Open Medicine
Objective The retrospective investigation was carried out to assess whether subjects who fulfilled our proposed recruitment criteria responded more favorably to anterior cruciate ligament reconstruction (ACLR) than those who did not. Methods We retrospectively analyzed 109 skeletally mature subjects (78 men and 31 women) according to the following proposed criteria of recruitment: (1) pre-injury Tegner activity score ≥7 and a wish to return to a professional sports activity, (2) residual knee instability following injury and/or (3) age <20 years at the operation. The primary outcome was an improvement between assessment A (before operation) and B (mean follow-up of 1.6 years) in the average score for four of the five Knee injury and Osteoarthritis Outcome Score (KOOS) subscales, covering pain, symptoms, difficulty in sports and recreational activities, and quality of life (KOOS4). Results The proposed recruitment criteria for ACLR were met by 58 subjects (53%). There were 49 subj...
Curēus, 2024
Introduction Anterior cruciate ligament (ACL) tears are common injuries that can considerably impact an individual's quality of life and athletic performance. In these cases, surgical reconstruction of the ligament can be considered to restore stability to the knee. This study aims to investigate the time taken for individuals to return to sport post-ACL reconstruction, assess the rate of re-injury and evaluate the reliability of the International Knee Documentation Committee (IKDC) and Knee Injury and Osteoarthritis Outcome Score (KOOS) scoring systems in predicting a return to sport at the pre-injury level. Methods In this retrospective study, a total of 104 patients who underwent ACL reconstruction between January 2016 and December 2022 by one surgical team at Mater Dei Hospital, Malta were evaluated using a selfadministered questionnaire. The questionnaire was based on different components including the sport practised at the time of injury, sport engagement classification, return to sport, the ability to return to preinjury levels of performance and re-injury. The participants then had to fill in IKDC and KOOS evaluation forms. Results In this study, 73% (n=76) of individuals successfully returned to sport after ACL reconstruction, with no significant difference being found between professional and recreational athletes (Chi-squared=0.00455, p=0.95). After reconstruction, 31.7% (n=33) of participants experienced an ipsilateral or contralateral ACL tear, with those returning to sport within six months showing a fivefold increase in re-injury risk compared to individuals who returned at eight or 12 months, suggesting a significant association between return duration and re-injury. The relationship between scoring systems and return to sport at the pre-injury level of performance was analysed using binary logistic regression, revealing that achieving scores of 85.6 or higher in IKDC or 89 or higher in KOOS meant having a 95% probability of returning to sport at the preinjury level. Conclusions By considering these scoring systems with other post-operative criteria, clinicians can offer a more customised rehabilitation plan tailored to each patient who undergoes ACL reconstruction.
Knee Surgery, Sports Traumatology, Arthroscopy, 2001
The World Health Organization's most recent version of the International Classification of Impairments, Disability and Handicaps categorizes disablement into physical impairments, activity limitations, and participation restrictions 41]. This biopsychosocial model represents the integration of the medical and social approach to human functioning and disablement. Similar to Nagi's [30] disablement scheme, a physical impairment can result from dysfunction and/or structural abnormality of a specific body system, such as the musculoskeletal system. Limitations in activity, according to the International Classification, refer to the nature and extent of an individual's function as a consequence of pathology or impairment. Limitations of activities may include restrictions in activities of daily living (ADL), such as ambulation and climbing stairs, or limitation in sports, such as running, cutting, and pivoting. The term participation refers to a person's involvement in basic areas of human life, such as self-care, work, sports, and recreation [41]. This classification scheme Abstract This study examined the relationship between impairment of the knee and activity restriction during activities of daily living and sports following anterior cruciate ligament reconstruction. Knee range of motion, swelling, pain, instability, ligamentous laxity, isometric and isokinetic muscle function and performance-based measures of activity restriction were measured in 44 subjects. Four measures of patient-reported activity restrictions, including the Activities of Daily Living, Sports Activities Scales of the Knee Outcome Survey, and global ratings of function during activities of daily life and sports, were statistically combined to create a composite variable representing the level of patient-reported activity restrictions for each subject. Hierarchical regression analysis revealed that 17% of the variability in patient-reported activity restrictions was accounted for by age, length of postoperative followup, and mechanism of injury. Addi-tion of the one-legged hop, Lachman, anterior drawer, and varus stress tests accounted for an additional 40% of the variability of function. When pain and giving way were added to the model, 79% of the variability was explained.
Journal of athletic training, 2018
Anterior cruciate ligament (ACL) reconstruction (ACLR) is the most commonly used method for helping athletes regain function and return to preinjury activity levels after ACL injury. Outcomes after ACLR have suggested that athletes return to a level of function that would support a return to sport participation; however, in a recent meta-analysis, pooled return rates were only 55%. It is unclear whether this discrepancy is a result of functional impairments. To compare patient-reported outcomes (PROs), dynamic balance, dynamic functional performance, strength, and muscular endurance in athletes who returned to sport (RTS) and athletes who did not return to sport (NRTS) after ACLR. Case-control study. University research laboratory. Two groups of participants with primary unilateral ACLR: 18 RTS individuals (7 males, 11 females; age = 23 ± 11 years, height = 163.58 ± 40.41 cm, mass = 70.00 ± 21.75 kg, time since surgery = 4.02 ± 3.20 years) and 12 NRTS individuals (5 males,...