Tegner level is predictive for successful return to sport 2 years after anterior cruciate ligament reconstruction.
ACL reconstruction
Rehabilitation
Return to sports
Tegner
Journal
Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA
ISSN: 1433-7347
Titre abrégé: Knee Surg Sports Traumatol Arthrosc
Pays: Germany
ID NLM: 9314730
Informations de publication
Date de publication:
Sep 2021
Sep 2021
Historique:
received:
06
07
2020
accepted:
13
10
2020
pubmed:
30
10
2020
medline:
27
8
2021
entrez:
29
10
2020
Statut:
ppublish
Résumé
For a successful return to sport (RTS) after an anterior cruciate ligament reconstruction (ACLR), patients are recommended to attend a comprehensive rehabilitation program, followed by an RTS assessment, that is a combination of tests. The purpose of this study was to predict a successful return to sport using the results of the RTS assessment and self-reported questionnaires at minimum 2 years after ACLR. A total of 123 consecutive ACLR patients undertook an intensive rehabilitation program followed by a comprehensive RTS assessment that included an established combination of balance and strength tests, the ACL-return to sport after Injury scale (ACL-RSI) questionnaire and a KT1000 laximetry test. Preinjury and expected Tegner and Lysholm were collected at baseline, at RTS and prospectively collected at minimum 2-year follow-up. The patients were asked if they returned to their previous sport and at which level. All variables were included in a regression analysis predicting a successful return to previous sport, return to the same level of sport as well as the Tegner level at 2 years. Sixty-two patients (50%) returned to their previous sport by the 2-year follow-up, without a difference in preinjury Tegner between these two groups (n.s.). Expected preoperative Tegner was the only significant predictor of a successful return to previous sport (p = 0.042; OR 1.300, 95% CI 1.010-1.672). Out of the 62 patients returning to their previous sport, 38 (61%) reported to be on the same or higher level. The only predictive variable for returning to the same level was the higher preinjury Tegner level (p = 0.048; OR 1.522). Multivariate regression analysis of Tegner level at 2 years found younger age to be the only predictive value. From the RTS assessment tests, the ACL-RSI questionnaire and the posterolateral balance test were predictive variables for Tegner at 2-year follow-up, albeit in the univariate regression analysis. Preoperative Tegner and expected Tegner level collected prior to an ACL reconstruction can aid in the objective prediction of patients' return to sport after 2 years. High-level athletes are more likely to return to their previous sport and to the previous level. Younger patients achieve a higher Tegner level at 2 years. Level III study.
Identifiants
pubmed: 33118063
doi: 10.1007/s00167-020-06335-4
pii: 10.1007/s00167-020-06335-4
pmc: PMC8384787
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
3010-3016Informations de copyright
© 2020. The Author(s).
Références
Ardern CL, Webster KE, Taylor NF, Feller JA (2011) Return to sport following anterior cruciate ligament reconstruction surgery: a systematic review and meta-analysis of the state of play. Br J Sports Med 45:596–606
pubmed: 21398310
doi: 10.1136/bjsm.2010.076364
Beischer S, HamrinSenorski E, Thomeé C, Samuelsson K, Thomeé R (2019) How is psychological outcome related to knee function and return to sport among adolescent athletes after anterior cruciate ligament reconstruction? Am J Sports Med 47:1567–1575
pubmed: 31095401
doi: 10.1177/0363546519843073
Branch TP, Mayr HO, Browne JE, Campbell JC, Stoehr A, Jacobs CA (2010) Instrumented examination of anterior cruciate ligament injuries: minimizing flaws of the manual clinical examination. Arthroscopy 26:997–1004
pubmed: 20620801
doi: 10.1016/j.arthro.2010.01.019
Briggs KK, Lysholm J, Tegner Y, Rodkey WG, Kocher MS, Steadman JR (2009) The reliability, validity, and responsiveness of the Lysholm score and Tegner activity scale for anterior cruciate ligament injuries of the knee: 25 years later. Am J Sports Med 37:890–897
pubmed: 19261899
doi: 10.1177/0363546508330143
Browning WM, Kluczynski MA, Curatolo C, Marzo JM (2017) Suspensory versus aperture fixation of a quadrupled hamstring tendon autograft in anterior cruciate ligament reconstruction: a meta-analysis. Am J Sports Med 45:2418–2427
pubmed: 28068159
doi: 10.1177/0363546516680995
Czuppon S, Racette BA, Klein SE, Harris-Hayes M (2014) Variables associated with return to sport following anterior cruciate ligament reconstruction: a systematic review. Br J Sports Med 48:356–364
pubmed: 24124040
doi: 10.1136/bjsports-2012-091786
Davies GJ, McCarty E, Provencher M, Manske RC (2017) ACL return to sport guidelines and criteria. Curr Rev Musculoskelet Med 10:307–314
pubmed: 28702921
pmcid: 5577421
doi: 10.1007/s12178-017-9420-9
Ellman MB, Sherman SL, Forsythe B, LaPrade RF, Cole BJ, Bach BR (2015) Return to play following anterior cruciate ligament reconstruction. J Am AcadOrthopSurg 23:283–296
Griffin LY, Albohm MJ, Arendt EA, Bahr R, Beynnon BD, Demaio M, Dick RW, Engebretsen L, Garrett WE, Hannafin JA, Hewett TE, Huston LJ, Ireland ML, Johnson RJ, Lephart S, Mandelbaum BR, Mann BJ, Marks PH, Marshall SW, Myklebust G, Noyes FR, Powers C, Shields C, Shultz SJ, Silvers H, Slauterbeck J, Taylor DC, Teitz CC, Wojtys EM, Yu B (2006) Understanding and preventing noncontact anterior cruciate ligament injuries: a review of the Hunt Valley II meeting, January 2005. Am J Sports Med 34:1512–1532
pubmed: 16905673
doi: 10.1177/0363546506286866
Grindem H, Snyder-Mackler L, Moksnes H, Engebretsen L, Risberg MA (2016) Simple decision rules can reduce reinjury risk by 84% after ACL reconstruction: the Delaware–Oslo ACL cohort study. Br J Sports Med 50:804–808
pubmed: 27162233
doi: 10.1136/bjsports-2016-096031
Gustavsson A, Neeter C, Thomeé P, Silbernagel KG, Augustsson J, Thomeé R, Karlsson J (2006) A test battery for evaluating hop performance in patients with an ACL injury and patients who have undergone ACL reconstruction. Knee Surg Sports TraumatolArthrosc 14:778–788
doi: 10.1007/s00167-006-0045-6
HamrinSenorski E, Samuelsson K, Thomeé C, Beischer S, Karlsson J, Thomeé R (2017) Return to knee-strenuous sport after anterior cruciate ligament reconstruction: a report from a rehabilitation outcome registry of patient characteristics. Knee Surg Sports TraumatolArthrosc 25:1364–1374
doi: 10.1007/s00167-016-4280-1
Harris JD, Abrams GD, Bach BR, Williams D, Heidloff D, Bush-Joseph CA, Verma NN, Forsythe B, Cole BJ (2014) Return to sport after ACL reconstruction. Orthopedics 37:e103–e108
pubmed: 24679194
Hefti F, Müller W, Jakob RP, Stäubli HU (1993) Evaluation of knee ligament injuries with the IKDC form. Knee Surg Sports TraumatolArthrosc 1:226–234
doi: 10.1007/BF01560215
Hertel J, Miller SJ, Denegar CR (2000) Intratester and intertester reliability during the star excursion balance tests. J Sport Rehabil 9:104–116
doi: 10.1123/jsr.9.2.104
Hoenig JM, Heisey DM (2001) The abuse of power. Am Stat 55:19–24
doi: 10.1198/000313001300339897
Juris PM, Phillips EM, Dalpe C, Edwards C, Gotlin RS, Kane DJ (1997) A dynamic test of lower extremity function following anterior cruciate ligament reconstruction and rehabilitation. J Orthop Sports PhysTher 26:184–191
doi: 10.2519/jospt.1997.26.4.184
Kitaguchi T, Tanaka Y, Takeshita S, Tsujimoto N, Kita K, Amano H, Kinugasa K, Tachibana Y, Natsuume T, Horibe S (2020) Importance of functional performance and psychological readiness for return to preinjury level of sports 1 year after ACL reconstruction in competitive athletes. Knee Surg Sports TraumatolArthrosc 28:2203–2212
doi: 10.1007/s00167-019-05774-y
Kyritsis P, Bahr R, Landreau P, Miladi R, Witvrouw E (2016) Likelihood of ACL graft rupture: not meeting six clinical discharge criteria before return to sport is associated with a four times greater risk of rupture. Br J Sports Med 50:946–951
pubmed: 27215935
doi: 10.1136/bjsports-2015-095908
Leys T, Salmon L, Waller A, Linklater J, Pinczewski L (2012) Clinical results and risk factors for reinjury 15 years after anterior cruciate ligament reconstruction: a prospective study of hamstring and patellar tendon grafts. Am J Sports Med 40:595–605
pubmed: 22184280
doi: 10.1177/0363546511430375
Loose O, Achenbach L, Fellner B, Lehmann J, Jansen P, Nerlich M, Angele P, Krutsch W (2018) Injury prevention and return to play strategies in elite football: no consent between players and team coaches. Arch Orthop Trauma Surg 138:985–992
pubmed: 29679206
doi: 10.1007/s00402-018-2937-6
Losciale JM, Bullock G, Cromwell C, Ledbetter L, Pietrosimone L, Sell TC (2019) Hop testing lacks strong association with key outcome variables after primary anterior cruciate ligament reconstruction: a systematic review. Am J Sports Med 48:5115–5122
McPherson AL, Feller JA, Hewett TE, Webster KE (2019a) Psychological readiness to return to sport is associated with second anterior cruciate ligament injuries. Am J Sports Med 47:857–862
pubmed: 30753794
doi: 10.1177/0363546518825258
McPherson AL, Feller JA, Hewett TE, Webster KE (2019b) Smaller change in psychological readiness to return to sport is associated with second anterior cruciate ligament injury among younger patients. Am J Sports Med 47:1209–1215
pubmed: 30786247
doi: 10.1177/0363546519825499
van Melick N, van Cingel REH, Brooijmans F, Neeter C, van Tienen T, Hullegie W, Nijhuis-van der Sanden MWG (2016) Evidence-based clinical practice update: practice guidelines for anterior cruciate ligament rehabilitation based on a systematic review and multidisciplinary consensus. Br J Sports Med 50:1506–1515
pubmed: 27539507
doi: 10.1136/bjsports-2015-095898
Mohtadi NG, Chan DS (2018) Return to sport-specific performance after primary anterior cruciate ligament reconstruction: a systematic review. Am J Sports Med 46:3307–3316
pubmed: 29028445
doi: 10.1177/0363546517732541
Moir GL (2008) Three different methods of calculating vertical jump height from force platform data in men and women. MeasPhysEducExercSci 12:207–218
Myrer JW, Schulthies SS, Fellingham GW (1996) Relative and absolute reliability of the KT-2000 arthrometer for uninjured knees. Testing at 67, 89, 134, and 178 N and manual maximum forces. Am J Sports Med 24:104–108
pubmed: 8638742
doi: 10.1177/036354659602400119
Nakamura K, Koga H, Sekiya I, Watanabe T, Mochizuki T, Horie M, Nakamura T, Otabe K, Muneta T (2017) Evaluation of pivot shift phenomenon while awake and under anaesthesia by different manoeuvres using triaxial accelerometer. Knee Surg Sports TraumatolArthrosc 25:2377–2383
doi: 10.1007/s00167-015-3740-3
Nawasreh Z, Logerstedt D, Cummer K, Axe MJ, Risberg MA, Snyder-Mackler L (2017) Do patients failing return-to-activity criteria at 6 months after anterior cruciate ligament reconstruction continue demonstrating deficits at 2 years? Am J Sports Med 45:1037–1048
pubmed: 28125899
doi: 10.1177/0363546516680619
Noyes FR, Barber SD, Mangine RE (1991) Abnormal lower limb symmetry determined by function hop tests after anterior cruciate ligament rupture. Am J Sports Med 19:513–518
pubmed: 1962720
doi: 10.1177/036354659101900518
Plisky PJ, Gorman PP, Butler RJ, Kiesel KB, Underwood FB, Elkins B (2009) The reliability of an instrumented device for measuring components of the star excursion balance test. N Am J Sports PhysTher 4:92–99
Rambaud AJM, Ardern CL, Thoreux P, Regnaux J-P, Edouard P (2018) Criteria for return to running after anterior cruciate ligament reconstruction: a scoping review. Br J Sports Med 52:1437–1444
pubmed: 29720478
doi: 10.1136/bjsports-2017-098602
Risberg MA, Holm I, Ekeland A (1995) Reliability of functional knee tests in normal athletes. Scand J Med Sci Sports 5:24–28
pubmed: 7882124
doi: 10.1111/j.1600-0838.1995.tb00006.x
Scholten RJPM, Opstelten W, van der Plas CG, Bijl D, Deville WLJM, Bouter LM (2003) Accuracy of physical diagnostic tests for assessing ruptures of the anterior cruciate ligament: a meta-analysis. J FamPract 52:689–694
Shea KG, Carey JL (2015) Management of anterior cruciate ligament injuries: evidence-based guideline. J Am AcadOrthopSurg 23:e1–e5
Sousa PL, Krych AJ, Cates RA, Levy BA, Stuart MJ, Dahm DL (2017) Return to sport: does excellent 6-month strength and function following ACL reconstruction predict midterm outcomes? Knee Surg Sports TraumatolArthrosc 25:1356–1363
doi: 10.1007/s00167-015-3697-2
Tay KS, Tan AHC (2018) Clinical outcomes, return to sports, and patient satisfaction after anterior cruciate ligament reconstruction in young and middle-aged patients in an asian population—A 2-year follow-up study. Arthroscopy 34:1054–1059
pubmed: 29305288
doi: 10.1016/j.arthro.2017.10.039
Tegner Y, Lysholm J (1985) Rating systems in the evaluation of knee ligament injuries. ClinOrthopRelat Res 198:43–49
Thomeé R, Neeter C, Gustavsson A, Thomeé P, Augustsson J, Eriksson B, Karlsson J (2012) Variability in leg muscle power and hop performance after anterior cruciate ligament reconstruction. Knee Surg Sports TraumatolArthrosc 20:1143–1151
doi: 10.1007/s00167-012-1912-y
Toole AR, Ithurburn MP, Rauh MJ, Hewett TE, Paterno MV, Schmitt LC (2017) Young athletes cleared for sports participation after anterior cruciate ligament reconstruction: how many actually meet recommended return-to-sport criterion cutoffs? J Orthop Sports PhysTher 47:825–833
Webster KE, Feller JA (2019) Expectations for return to preinjury sport before and after anterior cruciate ligament reconstruction. Am J Sports Med 47:578–583
pubmed: 30649903
doi: 10.1177/0363546518819454
Webster KE, Feller JA, Lambros C (2008) Development and preliminary validation of a scale to measure the psychological impact of returning to sport following anterior cruciate ligament reconstruction surgery. PhysTher Sport 9:9–15