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Young Athletes After Anterior Cruciate Ligament Reconstruction Cleared for Sports Participation: How Many Actually Meet Recommended Return-to-Sport Criteria Cutoffs?

Research paper by Allison R AR Toole, Matthew P MP Ithurburn, Mitchell J MJ Rauh, Timothy E TE Hewett, Mark V MV Paterno, Laura C LC Schmitt

Indexed on: 11 Oct '17Published on: 11 Oct '17Published in: The Journal of orthopaedic and sports physical therapy



Abstract

Study Design Prospective cohort study. Background While meeting objective criteria cutoffs are recommended prior to return-to-sport (RTS) following ACL reconstruction (ACLR), the number of young athletes meeting recommended cutoffs and their impact on longitudinal sports participation are unknown. Objectives To test the hypothesis that a higher proportion of young athletes who met recommended cutoffs would maintain the same level of sports participation over the year following RTS clearance compared to those who did not. Methods At the time of RTS clearance, the International Knee Documentation Committee subjective form (IKDC), quadriceps and hamstring strength limb-symmetry indices (LSI), and single-leg hop test LSI were assessed. Proportions of participants meeting individual (IKDC ≥90; strength and hop test LSI ≥90%) and combined cutoffs were calculated. Proportions of participants who continued at the same level of sports participation over the year following RTS clearance (assessed using Tegner Activity scores) were compared between those who met and did not meet cutoffs. Results Participants included 115 young athletes (88 females). The proportions meeting individual cutoffs ranged from 43.5% to 78.3%. The proportions meeting cutoffs for all hop tests, all strength tests, and all combined measures were 53.0%, 27.8%, and 13.9%, respectively. A higher proportion of participants who met cutoffs for both strength tests maintained the same level of sports participation over the year following RTS clearance than those who did not (81.3% vs. 60.2%; p=0.02). Conclusion The proportions of young athletes after ACLR recently cleared for RTS meeting combined criteria cutoffs were low. Those who met cutoffs for both strength tests maintained the same level of sports participation at higher proportions than those who did not. Level of Evidence Level 2b - Prognosis. J Orthop Sports Phys Ther, Epub 7 Oct 2017. doi:10.2519/jospt.2017.7227.