Abstract
Introduction & Aims: After an Anterior Cruciate Ligament Reconstruction (ACLR), many patients expect to Return To Sport (RTS) at their pre-injury level. But, unfortunately knee re-injury after ACLR is not uncommon. This study details the development and preliminary results of a simple, efficient, and evidence-based RTS assessment implemented in a clinical setting.
Methods: A literature search was conducted using the PubMed database for articles addressing factors influencing RTS or re-injury risk after ACLR. 27 studies met our inclusion criteria. The most frequent factors associated with return to sport and risk of re-injury were extracted and used to develop our assessment protocol, specifically, the type of tests and the pass/fail criteria. This included: Psychological questionnaires (ACL-RSI and IKDC), anthropometric measurements (height, weight, KT-1000 knee laxity, leg length) and physical tests (single leg Y-Balance test, and single leg hop for distance, hop for height, and side hop endurance).
Results: The protocol has included the most appropriate assessments from the literature, while also satisfying the criteria of being time efficient and simple to administer. It takes approximately 15-20 minutes inside a standard clinical room (approximately 5x3x2m in size), and has been successfully administered by a number of clinical staff with minimal training. For analysis, 150 ACLR patients were assessed (87 males, 63 females; 30±11.9yrs; 75.3±15.3kg, 173.1±9.3cm; 9.9±2.7months from surgery). The results indicate that many patients at the 9 month post-operative stage are not ready to return to sport; either physically, and/or psychologically. 71% of patients failed at least one component; 45% failed more than one component. There were differences between surgeons, and moderate correlations between some components, such as the side and distance hops (r=0.752), and % quad strength vertical hop (r=0.744). The most commonly failed component was the vertical hop test highlighting a potential deficit in leg strength and power, followed by the Y-balance tests. Motion capture analysis revealed that many patients, even with a pass score, exhibited a large limb asymmetry for joint range of motion and movement variability, particularly in the valgus/varus direction. This may be a more advanced predictor of re-injury, but further analysis can validate this in the future.
Conclusion(s): The protocol that was developed is simple and easy to use within a standard clinical setting. Preliminary results suggest that patients still have deficits in the ACLR limb that may lead to re-injury if returning to sport. Further analysis may reveal more substantial relationships, particularly as more patients return to activity.
Methods: A literature search was conducted using the PubMed database for articles addressing factors influencing RTS or re-injury risk after ACLR. 27 studies met our inclusion criteria. The most frequent factors associated with return to sport and risk of re-injury were extracted and used to develop our assessment protocol, specifically, the type of tests and the pass/fail criteria. This included: Psychological questionnaires (ACL-RSI and IKDC), anthropometric measurements (height, weight, KT-1000 knee laxity, leg length) and physical tests (single leg Y-Balance test, and single leg hop for distance, hop for height, and side hop endurance).
Results: The protocol has included the most appropriate assessments from the literature, while also satisfying the criteria of being time efficient and simple to administer. It takes approximately 15-20 minutes inside a standard clinical room (approximately 5x3x2m in size), and has been successfully administered by a number of clinical staff with minimal training. For analysis, 150 ACLR patients were assessed (87 males, 63 females; 30±11.9yrs; 75.3±15.3kg, 173.1±9.3cm; 9.9±2.7months from surgery). The results indicate that many patients at the 9 month post-operative stage are not ready to return to sport; either physically, and/or psychologically. 71% of patients failed at least one component; 45% failed more than one component. There were differences between surgeons, and moderate correlations between some components, such as the side and distance hops (r=0.752), and % quad strength vertical hop (r=0.744). The most commonly failed component was the vertical hop test highlighting a potential deficit in leg strength and power, followed by the Y-balance tests. Motion capture analysis revealed that many patients, even with a pass score, exhibited a large limb asymmetry for joint range of motion and movement variability, particularly in the valgus/varus direction. This may be a more advanced predictor of re-injury, but further analysis can validate this in the future.
Conclusion(s): The protocol that was developed is simple and easy to use within a standard clinical setting. Preliminary results suggest that patients still have deficits in the ACLR limb that may lead to re-injury if returning to sport. Further analysis may reveal more substantial relationships, particularly as more patients return to activity.
| Original language | English |
|---|---|
| Pages (from-to) | 1-2 |
| Number of pages | 2 |
| Journal | Asia-Pacific Journal of Sports Medicine, Arthroscopy, Rehabilitation and Technology |
| Volume | 13 |
| DOIs | |
| Publication status | Published - Jul 2018 |
| Externally published | Yes |
| Event | Asia-Pacific Knee, Arthroscopy and Sports Medicine Society (APKASS) Congress 2018 - Sydney, Australia Duration: 31 May 2018 → 2 Jun 2018 |