Purpose
This study aimed to identify independent predictive factors for return to sports (RTS) after anterior cruciate ligament (ACL) reconstruction in competitive-level athletes and to determine ...optimal cut-off values for these factors at 6 months after surgery.
Methods
A total of 124 competitive athletes (50 males and 74 females; mean age, 17.0 years; preinjury Tegner activity scale > 7) who underwent primary ACL reconstruction were enrolled. Assessments at 6 months after surgery consisted of knee functional tests quadriceps index, hamstrings index, and single-leg hop for distance (SLH) and 2 self-report questionnaires IKDC subjective score and ACL-Return to Sport after Injury scale (ACL-RSI). At 1 year after surgery, athletes were classified into the RTS group (
n
= 101) or non-RTS group (
n
= 23) based on self-reported sports activities. After screening possible predictive factors of RTS, multivariate logistic regression and receiver operating characteristic curve analyses were performed to identify independent factors.
Results
Multivariate logistic regression analysis identified SLH (odds ratio, 2.861 per 10 unit increase;
P
< 0.001) and ACL-RSI (odds ratio, 1.810 per 10 unit increase;
P
= 0.001) at 6 months as independent predictors of RTS at 1 year after surgery. Optimal cut-off values of SLH and ACL-RSI were 81.3% (sensitivity = 0.891; specificity = 0.609) and 55 points (sensitivity = 0.693; specificity = 0.826), respectively.
Conclusion
In competitive athletes, SLH < 81% and ACL-RSI < 55 points at 6 months after surgery were associated with a greater risk of unsuccessful RTS at 1 year after surgery. SLH and ACL-RSI at 6 months could serve as screening tools to identify athletes who have difficulties with returning to sports after ACL reconstruction.
Level of evidence
III.
To determine whether preoperative quadriceps strength predicts the likelihood of return to sports (RTS) following anterior cruciate ligament reconstruction (ACLR) in competitive athletes.
...Case-control study.
Single-center.
A total of 221 competitive athletes who underwent primary ACLR were followed and divided into RTS (n = 177) and non-RTS (n = 44) groups based on self-reported sports activities at one year postoperatively.
Isokinetic quadriceps strength tests were performed preoperatively and at six months and one year postoperatively, and the quadriceps index (QI) was calculated. Functional performance was evaluated by the single-leg hop (SLH) test at six months postoperatively.
Preoperative QI significantly predicted the likelihood of RTS (odds ratio, 1.68 per 10-unit increase; P < 0.001), with a preoperative QI cut-off of 66% (AUC: 0.74; sensitivity: 68.9%; specificity: 77.3%). Subjects with a preoperative QI < 66% had a significantly lower postoperative QI, SLH, and rates of RTS compared to those with a higher preoperative QI (P < 0.01).
Preoperative quadriceps strength could predict the likelihood of RTS following ACLR, and a preoperative QI < 66% was associated with a greater risk of unsuccessful RTS at one year postoperatively. Preoperative QI should be evaluated as a predictor of RTS.
•RTS is an important consideration among athletes who underwent ACLR.•Preoperative QI could predict the likelihood of RTS, with a cut-off of 66%.•Athletes with low preoperative QI had significantly low postoperative knee function.•Preoperative QI should be evaluated as a predictor of RTS.
Purpose: The purpose of this study was to evaluate active knee flexion range of motion and hamstring strength following hamstring anterior cruciate ligament (ACL) reconstruction. Type of Study: Case ...control study, consecutive sample. Methods: Seventy-four consecutive patients who had undergone hamstring ACL reconstruction underwent isokinetic muscle strength testing at 2 years post surgery. Measurements of the maximum standing active knee flexion angle with the hip extended were also taken. During isokinetic testing, we evaluated flexion torque at 90° of knee flexion, in addition to the peak flexion torque. We further compared these parameters of muscle strength around the knee for the patients in whom only semitendinosus tendon was harvested as a graft source (ST group), and those from whom the semitendinosus tendon and the gracilis tendon were harvested (ST/G group). Results: Isokinetic testing showed that, in both the ST and ST/G groups, the knee flexor strength of the involved leg was less effectively restored at 90° of knee flexion than at the angle at which the peak torque was generated. Conversely, no significant difference was seen in the side-to-side ratio in either the peak flexion torque or the 90° flexion torque between the groups. The side-to-side ratio in mean maximum standing knee flexion angle was significantly lower in the ST/G group than in the ST group. Conclusions: This study suggests that the loss of knee flexor strength following the harvest of the hamstring tendons may be more significant than has been previously estimated. Furthermore, multiple tendon harvest may affect the range of active knee flexion.
Arthroscopy: The Journal of Arthroscopic and Related Surgery, Vol 18, No 6 (July-August), 2002: pp 598–602
Purpose: This study aimed to conduct a survey on postoperative return-to-work (RTW) status and problems related among patients undergoing orthopedic surgery.Methods: A total of 105 workers who ...underwent orthopedic surgeries underwent a self-administered survey questionnaire at 6 months after surgery. The questionnaire included questions about patient attributes, RTW status, period for RTW, and problems related to RTW (symptoms or difficulty performing work-related movements when returning to work and reasons for not RTW).Results: The questionnaire response rate was 63% (66 patients). The rate of RTW was 89% (59 patients). Regarding problems related to RTW, 63% of those who returned to work had symptoms or difficulty performing work-related movements. The most common symptom observed upon RTW was pain (10 patients, 17% of those returning to work). The most common difficulty performing work-related movements was squatting (9 patients, 15% of those returning to work). Five out of 7 respondents indicated that the reasons for not RTW were due to physical problems.Conclusion: Among the postoperative orthopedic patients, 89% returned to work. However, 63% of those who returned to work had symptoms or difficulty performing work-related movements. More than half of the patients who could not return to work responded that physical problems was the reason behind not returning to work, suggesting the need for considering more effective exercise therapy and guidance focusing on returning to work.
Purpose: This study aimed to conduct a survey on postoperative return-to-work (RTW) status and problems related among patients undergoing orthopedic surgery.Methods: A total of 105 workers who ...underwent orthopedic surgeries underwent a self-administered survey questionnaire at 6 months after surgery. The questionnaire included questions about patient attributes, RTW status, period for RTW, and problems related to RTW (symptoms or difficulty performing work-related movements when returning to work and reasons for not RTW).Results: The questionnaire response rate was 63% (66 patients). The rate of RTW was 89% (59 patients). Regarding problems related to RTW, 63% of those who returned to work had symptoms or difficulty performing work-related movements. The most common symptom observed upon RTW was pain (10 patients, 17% of those returning to work). The most common difficulty performing work-related movements was squatting (9 patients, 15% of those returning to work). Five out of 7 respondents indicated that the reasons for not RTW were due to physical problems.Conclusion: Among the postoperative orthopedic patients, 89% returned to work. However, 63% of those who returned to work had symptoms or difficulty performing work-related movements. More than half of the patients who could not return to work responded that physical problems was the reason behind not returning to work, suggesting the need for considering more effective exercise therapy and guidance focusing on returning to work.
