2017 ISAKOS Biennial Congress ePoster #1047

 

Return to Sport after Anterior Cruciate Ligament Reconstruction

João V. Novaretti, MD, São Paulo, SP BRAZIL
Carlos E. D. Franciozi, MD, PhD, Prof., São Paulo, SP BRAZIL
Andrea Forgas, PT, São Paulo, SP BRAZIL
Pedro Henrique Sasaki, PT, Sao Paulo BRAZIL
Sheila J. M. Ingham, MD, PhD, São Paulo, SP BRAZIL
Rene J. Abdalla, MD, PhD, São Paulo, SP BRAZIL

Federal University of Sao Paulo - Escola Paulista de Medicina, Sao Paulo, Sao Paulo, BRAZIL

FDA Status Cleared

Summary

Correlation between factors associated with better rate of return to pre-injury level of sports activity at six months after anterior cruciate ligament reconstruction.

Abstract

Background

There is a lack of literature-based objective criteria for return to sport after anterior cruciate ligament (ACL) injury. The establishment of such objective criteria is substantial to improve the rate of return to practice at the same pre-injury level, reduce the risk of re-injury, and determine when a patient can return to sport after ACL reconstruction (ACLR).

Purpose

To correlate factors associated with better rate of return to the sport at six months after surgery.

Study Design: Cohort study

Methods

Fifty-eight patients underwent ACLR. Six months after surgery, patients were submitted to arthrometry tests with KT-2000 arthrometer, isokinetic evaluation, static and dynamic stability tests and to the drop-jump video screening test. Also, patients completed the questionnaires International Knee Documentation Committee (IKDC), Lysholm and Tegner with at least one year after surgery.

Results

The rate of return to sport at the pre-injury level and to some sports activity were respectively 53.4% and 84.4%. The group with an IKDC Excellent/Good presented a difference in arthrometry (operated minus the non-operated limb (Mean O-N)) higher than the group with IKDC Regular/Bad (p=0.01). The group with Lysholm Excellent/Good presented a greater Mean O-N than the group with Lysholm Regular/Bad (p=0.01). The group ranging from less than or equal to zero difference from Tegner values after surgery and before lesion had a Mean O-N greater than the group with positive difference of Tegner values (p=0.007). The higher the Mean O-N value, the lower the hamstring muscle peak torque (p=0.04).

Conclusion

The best predictor of return to pre-injury level of sports after ACLR, at 6 months postoperatively, was higher tibia anterior displacement of the operated limb compared to the non-operated. This higher displacement, although <3mm compared to the contralateral limb, also related to a lower hamstring muscle peak torque in the operated limb and with higher IKDC, Lysholm and Tegner values following the patients. The deficit of quadriceps strength, regardless of the used cutoff value (80 or 90%), did not predict the return to the pre-injury sporting level, at the 6 months post-op evaluation.