Perspective from Robin V. West, MD
Disclosures: This study was funded by Western Norway Regional Health Authority and The Norwegian Fund for Post-Graduate Training in Physiotherapy.
April 23, 2021
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Age, psychological readiness may predict return to sport after ACL reconstruction

Perspective from Robin V. West, MD
Disclosures: This study was funded by Western Norway Regional Health Authority and The Norwegian Fund for Post-Graduate Training in Physiotherapy.
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Published results showed age and psychological readiness had a better predictive value of return to sport 2 years after ACL reconstruction than functional tests, which had no predictive value.

Anne Gro Heyn Faleide, PT, MSC, and colleagues collected single-leg hop test, isokinetic strength test, the IKDC Subjective Knee Form 2000, a custom-made return to sport questionnaire and the anterior cruciate ligament-return to sport after injury (ACL-RSI) scale among 129 patients who underwent ACL reconstruction. Researchers defined return to sport criteria as an IKDC 2000 score of 85% or greater and 85% or greater leg symmetry index on hop and strength tests. Researchers registered further knee surgery and reinjuries and patients completed another return to sport questionnaire at 2-year follow-up. To study the predictive ability of the test battery, researchers performed regression analyses and receiver operating characteristic analyses.

Results showed 42% of 103 patients who completed the 2-year follow-up returned to their preinjury level of sport. Researchers found return to sport was predicted by ACL-RSI 9 months score after surgery and age, with patients with an ACL-RSI of less than 47 at risk of not returning to sport. However, the functional tests did not predict return to sport, according to results. Researchers noted six patients sustained ACL reinjuries and seven patients underwent surgery for other knee complaints or injuries after return to sport testing. Of the 29 patients who passed all return to sport criteria and were cleared for return to sport, results showed no patients sustained a second knee injury.

Anne Gro Heyn Faleide
Anne Gro Heyn Faleide

“This study may have a future impact on orthopedics by contributing to the knowledge about what the different return to sport tests actually tells us. The importance of including psychological factors in the assessments is highlighted,” Faleide told Healio Orthopedics. “Further, the role of functional tests needs clarification: They do not seem to be informative on ability to return to sport, but are they informative about reinjury risk? It is a hope that this study will encourage a critical view on what tests we perform and how we interpret them when we advise our patients on return to sport.”