Knee function, strength, and resumption of preinjury sports participation in young athletes following anterior cruciate ligament reconstruction

Academic Article

Abstract

  • Copyright © 2019 Journal of Orthopaedic & Sports Physical Therapy®. All rights reserved. BACKGROUND: Following anterior cruciate ligament reconstruction (ACLR), young athletes demonstrate deficits in knee function and strength whose association with successful return to prein-jury sports participation is not well understood. OBJECTIVES: To examine differences in knee function and strength at the time of return-to-sport clearance between young athletes who successfully resumed preinjury sports participation, those who did not resume preinjury sports participation, and those who sustained a second anterior cruciate ligament (ACL) injury by 1 year following return-to-sport clearance. METHODS: This prospective cohort study collected data in 124 young athletes (mean ± SD age, 17.1 ± 2.4 years) at the time of return-to-sport clearance post ACLR. Measures included the Knee injury and Osteoarthritis Outcome Score (KOOS), single-leg hop tests, isokinetic quadriceps and hamstring strength, and limb symmetry during hop tests and strength tests. Participants were allocated to 3 groups: resumed preinjury sports participation (Tegner score), did not resume preinjury sports participation, or sustained a second ACL injury. Group differences were compared using Kruskal-Wallis tests and Mann-Whitney U post hoc tests. RESULTS: Seventy (56%) participants successfully resumed preinjury sports participation and 26 (21%) sustained a second ACL injury by 1 year post return-to-sport clearance. Participants who successfully resumed preinjury sports participation demonstrated greater absolute performance at return-to-sport clearance in the involved and uninvolved limbs on the triple hop (P = .007 and P = .004, respectively) and the crossover hop (P = .033 and P = .037, respectively), and in the involved limb on the single hop (P = .043), compared to those who did not (n = 28). Participants who sustained a second ACL injury demonstrated greater absolute performance at return-to-sport clearance in the involved and uninvolved limbs on the triple hop (P = .034 and P = .027, respectively) compared to those who did not resume preinjury sports participation. There were no group differences between those who successfully resumed preinjury levels of sports participation and those who sustained a second ACL injury. CONCLUSION: Following ACLR, the small proportion of young athletes who successfully resumed preinjury levels of sports participation 1 year after return to sport demonstrated greater absolute functional performance at the time of return-to-sport clearance. No differences were identified between those who successfully resumed preinjury sports participation and those who sustained a second ACL injury. Measures of limb symmetry did not differ among any of the groups.
  • Digital Object Identifier (doi)

    Author List

  • Ithurburn MP; Longfellow MA; Thomas S; Paterno MV; Schmitt LC
  • Start Page

  • 145
  • End Page

  • 153
  • Volume

  • 49
  • Issue

  • 3