Return to knee-strenuous sport after anterior cruciate ligament reconstruction: a report from a rehabilitation outcome registry of patient characteristics

Abstract

Purpose: To characterise patients who returned to knee-strenuous sports after an anterior cruciate ligament (ACL) reconstruction. Methods: Data from isotonic tests of muscle function and patient-reported outcome measures, Tegner activity scale (Tegner and Lysholm in Clin Orthop Relat Res 198:43–49, 1985), physical activity scale, knee injury and osteoarthritis scale and knee self-efficacy scale were extracted from a registry. The 157 included patients, 15–30 years of age, had undergone primary ACL reconstruction and were all involved in knee-strenuous sports, i.e. pre-injury Tegner of 6 or higher. Return to sport was studied in two different ways: return to pre-injury Tegner and return to knee-strenuous sport (Tegner 6). Results: Fifty-two patients (33 %), who returned to pre-injury Tegner, 10 months after surgery, were characterised by better subjective knee function measured with the knee injury and osteoarthritis outcome score (p < 0.05), compared with patients who did not. These patients also had higher perceived self-efficacy of knee function (p < 0.01), measured with knee self-efficacy scale. Eighty-four patients (54 %) who returned to knee-strenuous sports, i.e. Tegner 6 or higher, were characterised by higher goals for physical activity (p < 0.01) and higher self-efficacy of future knee function (p < 0.05). Strength measurements showed that women who returned to sports were stronger in leg extension than women who did not. No differences were found in Limb Symmetry Index for knee strength or jumping ability. Conclusion: Patients who returned to sports after ACL reconstruction had better subjective knee function and higher self-efficacy of knee function. Results highlight that further emphasis should be placed at psychological factors during rehabilitation of patients after ACLR. Level of evidence: II.