2015 ISAKOS Biennial Congress ePoster #1350

Back to Sports Following ACL Reconstruction - How Long do we Have to Wait?

Elmar Herbst, MD, PhD, Münster GERMANY
Christian Hoser, MD, Innsbruck AUSTRIA
Caroline Hepperger, Mag., Innsbruck AUSTRIA
Christian Raschner, Ass-Prof., MD, Innsbruck AUSTRIA
Carolin Hildebrandt, PhD, Innsbruck AUSTRIA
Christian Fink, MD, Prof., Innsbruck AUSTRIA

OSM Research Foundation, Innsbruck, AUSTRIA

FDA Status Not Applicable

Summary: At 8 month postoperatively and after completing a novel test battery including one- and two-legged jumping and stability tests following ACL reconstruction, only 15.9 % of the patients were ready for a “safe” return to sports when compared to normative data.

Rate:

Abstract:

Purpose

The purpose of this study was the utilization of a novel ACL test battery to determine a safe return to sports following ACL reconstruction.

Methods

In total 69 patients, 27 (39.13 %) female (mean age: 20.89 ± 7.79 yrs.) and 42 (60.87 %) male (mean age: 21.52 ± 5.71 yrs.), were included in this prospective study. 30 (43.48 %) patients injured their non-dominant leg, whereas 39 (56.52 %) injured their dominant leg. All patients were subjected to a standardized early rehabilitation protocol immediately after surgery and until a return to play was possible. All patients performed the “back in action” test battery consisting of one- and two-legged stability tests, counter movement jumps, speedy jumps, plyometric jumps and a quick feed test. The first test was 5.6 months and the re-test 8 months postoperatively. The values of the different subtests were compared with normative data of healthy, gender and age-matched controls to determine the time point for a safe return to sports.
To determine possible differences between test values of patients who were ready for a return to play and patients who had deficits, the Student´s t test or Mann-Whitney U test were used, depending on data distribution. To evaluate the progress during physical therapy between test and re-test, a matched pair analysis using the Student´s t test or the Wilcoxon test, depending on data distribution, was used. Statistical significance was accepted for p < 0.05.

Results

After the first and second test battery, 15.9 % and 17.4 % of the patients met the criteria for a return to non-competitive sports. However, only 1 patient was ready for a return to competitive sports after completing the test battery for the second time. The most limiting factor were poor LSI values of < 90 % if the dominant leg was involved and < 80 % if the non-dominant leg was involved. A significant improvement through physical therapy between the first and second completion of the test battery for most subtests was detected (p < 0.05).

Conclusion

This test battery demonstrates, that in terms of neuromuscular abilities most patients are not ready for a safe return to sports compared to healthy controls at 8 months postoperatively. However, a definitive decision for a safe return to sports should further consider individual patient-related factors and sports related demands.

Clinical relevance: The “back in action” test battery is practicable. It takes about 40 minutes and can be carried out in one room with little equipment. The test battery allows the determination of a “safe” return to (competitive) sports following ACL reconstruction according to the collected and categorized normative data of a healthy population.