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Am J Sports Med. 2015 Apr;43(4):848-56. doi: 10.1177/0363546514563282. Epub 2015 Jan 12.

Sports participation 2 years after anterior cruciate ligament reconstruction in athletes who had not returned to sport at 1 year: a prospective follow-up of physical function and psychological factors in 122 athletes.

Author information

1
School of Allied Health, La Trobe University, Melbourne, Australia Division of Physiotherapy, Linköping University, Linköping, Sweden c.ardern@latrobe.edu.au.
2
School of Allied Health, La Trobe University, Melbourne, Australia.
3
School of Allied Health, La Trobe University, Melbourne, Australia OrthoSport Victoria, Epworth Healthcare, Melbourne, Australia.
4
OrthoSport Victoria, Epworth Healthcare, Melbourne, Australia.

Abstract

BACKGROUND:

A return to their preinjury level of sport is frequently expected within 1 year after anterior cruciate ligament (ACL) reconstruction, yet up to two-thirds of athletes may not have achieved this milestone. The subsequent sports participation outcomes of athletes who have not returned to their preinjury level sport by 1 year after surgery have not previously been investigated.

PURPOSE:

To investigate return-to-sport rates at 2 years after surgery in athletes who had not returned to their preinjury level sport at 1 year after ACL reconstruction.

STUDY DESIGN:

Case series; Level of evidence, 4.

METHODS:

A consecutive cohort of competitive- and recreational-level athletes was recruited prospectively before undergoing ACL reconstruction at a private orthopaedic clinic. Participants were followed up at 1 and 2 years after surgery with a sports activity questionnaire that collected information regarding returning to sport, sports participation, and psychological responses. An independent physical therapist evaluated physical function at 1 year using hop tests and the International Knee Documentation Committee knee examination form and subjective knee evaluation.

RESULTS:

A group of 122 competitive- and recreational-level athletes who had not returned to their preinjury level sport at 1 year after ACL reconstruction participated. Ninety-one percent of the athletes returned to some form of sport after surgery. At 2 years after surgery, 66% were playing sport, with 41% playing their preinjury level of sport and 25% playing a lower level of sport. Having a previous ACL reconstruction to either knee, poorer hop-test symmetry and subjective knee function, and more negative psychological responses were associated with not playing the preinjury level sport at 2 years.

CONCLUSION:

Most athletes who were not playing sport at 1 year had returned to some form of sport within 2 years after ACL reconstruction, which may suggest that athletes can take longer than the clinically expected time of 1 year to return to sport. However, only 2 of every 5 athletes were playing their preinjury level of sport at 2 years after surgery. When the results of the current study were combined with the results of athletes who had returned to sport at 1 year, the overall rate of return to the preinjury level sport at 2 years was 60%. Demographics, physical function, and psychological factors were related to playing the preinjury level sport at 2 years after surgery, supporting the notion that returning to sport after surgery is multifactorial.

KEYWORDS:

ACL; anterior cruciate ligament; orthopaedic; psychology; return to sport; sport

PMID:
25583757
DOI:
10.1177/0363546514563282
[Indexed for MEDLINE]

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