Decision To Return To Sport Participation After Anterior Cruciate Ligament Reconstruction, Part II: Self-Reported And Functional Performance Outcomes

ASU Author/Contributor (non-ASU co-authors, if there are any, appear on document)
Jennifer Howard, Assistant Professor, PhD (Creator)
Appalachian State University (ASU )
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Abstract: Context: 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. Objective: 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. Design: Case-control study. Setting: University research laboratory. Patients or Other Participants: 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, 7 females; age = 26 ± 13 years, height = 171.33 ± 48.24 cm, mass = 72.00 ± 21.81 kg, time since surgery = 3.68 ± 2.71 years). Results: Compared with the RTS group, the NRTS group had lower scores on the International Knee Documentation Committee Subjective Knee Evaluation Form (RTS median = 92.52, range = 66.67–97.70; NRTS median = 82.76, range = 63.22–96.55; P = .03) and Knee Injury and Osteoarthritis Outcome Score Symptoms subscale (RTS median = 88, range = 54–100; NRTS median = 71, range= 54–100; P = .08). No differences were observed for any functional performance measures. Conclusions: The NRTS athletes displayed lower PROs despite demonstrating similar function on a variety of physical performance measures. These results further support existing evidence that physical performance alone may not be the ideal postoperative outcome measure. Measures of patients' symptoms and self-perceived physical function may also greatly influence postoperative activity choices.

Additional Information

Jennifer L. Werner, Julie P. Burland, Carl G. Mattacola, Jenny Toonstra, Robert A. English, and Jennifer S. Howard (2018). Decision to Return to Sport Participation After Anterior Cruciate Ligament Reconstruction, Part II: Self-Reported and Functional Performance Outcomes. Journal of Athletic Training: May 2018, Vol. 53, No. 5, pp. 464-474. Publisher version of record available at:
Language: English
Date: 2018
patient-reported outcomes, Star Excursion Balance Test, single-legged–hop tests, isokinetic strength

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