Return to Sport (RTS) After Anterior Cruciate Ligament Reconstruction: Which Factors Influence the RTS Decision?

Background It is unknown which valid criteria should be considered to justify the decision for return to sport (RTS) following anterior cruciate ligament reconstruction (ACLR). The research question is whether gender, age, the outcome of the isokinetic maximal strength measurement and the single-leg hop test (quantitative/qualitative) influence the decision for RTS nine months after ACLR. Methods This study is a retrospective data analysis. The research question was evaluated with a multiple logistic regression analysis (MLR). The dependent variable, RTS yes/no, is based on the decision of the orthopaedist in charge of treatment nine months (+/- 30 days) after ACLR. The following possible influencing factors were investigated: gender, age, limb symmetry index (LSI) of maximal knee extension and knee flexion strength at 60 degrees/sec., LSI of single-leg hop test and evaluation of knee valgus. Results Data of 71 patients were included for MLR. The odds ratios (OR) for RTS increased with female gender (OR, 4.808; p = 0.035), a higher LSI of maximal strength of knee extension (OR, 1.117; p = 0.009) and a higher LSI of the single-leg hop test (OR, 1.125; p = 0.020). Age, the LSI of maximal strength of knee flexion and knee valgus had no influence on the RTS decision. Conclusion Gender and the limb symmetry indexes of the maximal strength of knee extension and of the single-leg hop test are associated with RTS nine months after ACLR. These results should be considered to optimise rehabilitation after ACLR.

Automated summary

This study aimed to investigate the influence of gender, age, isokinetic maximal strength measurement, and single-leg hop test on the decision for returning to sport nine months after ACL reconstruction. The results showed that female gender, higher limb symmetry indexes of maximal strength and single-leg hop test were associated with a higher likelihood of returning to sport. Age, limb symmetry index of maximal strength of knee flexion, and knee valgus had no influence on the decision.