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Title: 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.
Epworth Authors: Feller, Julian
Whitehead, Timothy
Other Authors: Ardern, Clare
Taylor, Nicholas
Webster, Kate
Keywords: Hop Tests
Anterior Cruciate Ligament
Anterior Cruciate Ligament Reconstruction
Athletic Injuries
Follow-Up Studies
Knee Joint
Return to Sport
Recovery of Function
Psychology, Sports
Sports Medicine
Time Factors
Young Adult
Musculoskeletal Clinical Institute, Epworth HealthCare, Victoria, Australia
Issue Date: Apr-2015
Publisher: Sage Publications
Citation: American Journal of Sports Medicine. 2015 Apr;43(4):848-56.
Abstract: BACKGROUND: A return to their pre-injury 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 pre-injury 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 pre-injury 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 pre-injury 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 pre injury 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 pre-injury 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 pre-injury 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 pre-injury level sport at 2 years was 60%. Demographics, physical function, and psychological factors were related to playing the pre-injury level sport at 2 years after surgery, supporting the notion that returning to sport after surgery is multifactorial.
DOI: 10.1177/0363546514563282
PubMed URL:
ISSN: 0363-5465
Journal Title: American Journal of Sports Medicine
Type: Journal Article
Affiliated Organisations: School of Allied Health, La Trobe University, Melbourne, Victoria, Australia.
Division of Physiotherapy, Linköping University, Linköping, Sweden.
Type of Clinical Study or Trial: Case Series and Case Reports
Appears in Collections:Mental Health

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