Return to Preinjury Sports Participation Following Anterior Cruciate Ligament Reconstruction: Contributions of Demographic, Knee Impairment, and Self-report Measures
- 1 November 2012
- journal article
- Published by Journal of Orthopaedic & Sports Physical Therapy (JOSPT) in Journal of Orthopaedic & Sports Physical Therapy
- Vol. 42 (11), 893-901
- https://doi.org/10.2519/jospt.2012.4077
Abstract
Study Design Cross-sectional cohort. Objectives (1) To examine differences in clinical variables (demographics, knee impairments, and self-report measures) between those who return to preinjury level of sports participation and those who do not at 1 year following anterior cruciate ligament reconstruction, (2) to determine the factors most strongly associated with return-to-sport status in a multivariate model, and (3) to explore the discriminatory value of clinical variables associated with return to sport at 1 year postsurgery. Background Demographic, physical impairment, and psychosocial factors individually prohibit return to preinjury levels of sports participation. However, it is unknown which combination of factors contributes to sports participation status. Methods Ninety-four patients (60 men; mean age, 22.4 years) 1 year post-anterior cruciate ligament reconstruction were included. Clinical variables were collected and included demographics, knee impairment measures, and self-report questionnaire responses. Patients were divided into “yes return to sports” or “no return to sports” groups based on their answer to the question, “Have you returned to the same level of sports as before your injury?” Group differences in demographics, knee impairments, and self-report questionnaire responses were analyzed. Discriminant function analysis determined the strongest predictors of group classification. Receiver-operating-characteristic curves determined the discriminatory accuracy of the identified clinical variables. Results Fifty-two of 94 patients (55%) reported yes return to sports. Patients reporting return to preinjury levels of sports participation were more likely to have had less knee joint effusion, fewer episodes of knee instability, lower knee pain intensity, higher quadriceps peak torque-body weight ratio, higher score on the International Knee Documentation Committee Subjective Knee Evaluation Form, and lower levels of kinesiophobia. Knee joint effusion, episodes of knee instability, and score on the International Knee Documentation Committee Subjective Knee Evaluation Form were identified as the factors most strongly associated with self-reported return-to-sport status. The highest positive likelihood ratio for the yes-return-to-sports group classification (14.54) was achieved when patients met all of the following criteria: no knee effusion, no episodes of instability, and International Knee Documentation Committee Subjective Knee Evaluation Form score greater than 93. Conclusion In multivariate analysis, the factors most strongly associated with return-to-sport status included only self-reported knee function, episodes of knee instability, and knee joint effusion. Level of Evidence Prognosis, level 2b. J Orthop Sports Phys Ther 2012;42(11):893–901, Epub 2 August 2012. doi:10.2519/jospt.2012.4077Keywords
This publication has 61 references indexed in Scilit:
- Incidence of Contralateral and Ipsilateral Anterior Cruciate Ligament (ACL) Injury After Primary ACL Reconstruction and Return to SportClinical Journal of Sport Medicine, 2012
- Factors Used to Determine Return to Unrestricted Sports Activities After Anterior Cruciate Ligament ReconstructionArthroscopy: The Journal of Arthroscopic & Related Surgery, 2011
- Return to sport following anterior cruciate ligament reconstruction surgery: a systematic review and meta-analysis of the state of playBritish Journal of Sports Medicine, 2011
- Return to the Preinjury Level of Competitive Sport After Anterior Cruciate Ligament Reconstruction SurgeryThe American Journal of Sports Medicine, 2010
- Biomechanical Measures during Landing and Postural Stability Predict Second Anterior Cruciate Ligament Injury after Anterior Cruciate Ligament Reconstruction and Return to SportThe American Journal of Sports Medicine, 2010
- Time Line for Noncopers to Pass Return-to-Sports Criteria After Anterior Cruciate Ligament ReconstructionJournal of Orthopaedic & Sports Physical Therapy, 2010
- Psychometric properties of the shortened disabilities of the Arm, Shoulder, and Hand Questionnaire (QuickDASH) and Numeric Pain Rating Scale in patients with shoulder painJournal of Shoulder and Elbow Surgery, 2009
- Choosing surgery: patients' preferences within a trial of treatments for anterior cruciate ligament injury. A qualitative studyBMC Musculoskeletal Disorders, 2009
- Factors Associated With Function After Anterior Cruciate Ligament ReconstructionSports Health: a Multidisciplinary Approach, 2009
- Neuromuscular Training Techniques to Target Deficits Before Return to Sport After Anterior Cruciate Ligament ReconstructionJournal of Strength and Conditioning Research, 2008