https://pubmed.ncbi.nlm.nih.gov/28223305/

Original article.

Eighty-three per cent of elite athletes return to preinjury sport after anterior cruciate ligament reconstruction: a systematic review with meta-analysis of return to sport rates, graft rupture rates and performance outcomes

Courtney C H Lai 1, Clare L Ardern 1 2 3, Julian A Feller 4, Kate E Webster 1
Affiliations

Free article

Abstract

Objectives: The primary objective was to calculate the rate of return to sport (RTS) following anterior cruciate ligament (ACL) reconstruction in elite athletes. Secondary objectives were to estimate the time taken to RTS, calculate rates of ACL graft rupture, evaluate postsurgical athletic performance and identify determinants of RTS.

Design: Pooled RTS and graft rupture rates were calculated using random effects proportion meta-analysis. Time to RTS, performance data and determinants of RTS were synthesised descriptively.

Data sources: MEDLINE, EMBASE, AMED, CINAHL, AMI, PEDro, SPORTDiscus and The Cochrane Library were searched from inception to 19 January 2016. Hand searching of 10 sports medicine journals and reference checking were also performed.

Eligibility criteria for selecting studies: Studies were included if they reported the ratio of elite athletes who returned to their preinjury level of sport following ACL reconstruction. Twenty-four studies were included.

Results: The pooled RTS rate was 83% (95% CI 77% to 88%). The mean time to RTS ranged from 6 to 13 months. The pooled graft rupture rate was 5.2% (95% CI 2.8% to 8.3%). Six out of nine studies that included a noninjured control group found no significant deterioration in athletic performance following ACL reconstruction. Indicators of greater athletic skill or value to the team were associated with RTS.

Summary and conclusions: Eighty-three per cent of elite athletes returned to sport following ACL reconstruction, while 5.2% sustained a graft rupture. Most athletes who returned to sport performed comparably with matched, uninjured controls. This information may assist in guiding expectations of athletes and clinicians following ACL reconstruction.

Keywords: anterior cruciate ligament; anterior cruciate ligament reconstruction; elite athletes; sport re-entry.

Conflict of interest statement

Competing interests: None declared.

 

 

CORE Physical Therapy in Omaha Explains…

By Dr. Mark Rathjen PT DPT CSCS

Co-owner and Head clinician at CORE Physical Therapy and Sports Performance.

“Eighty-three per cent of elite athletes returned to sport following ACL reconstruction, while 5.2% sustained a graft rupture. Most athletes who returned to sport performed comparably with matched, uninjured controls.” “return to sports 6-13 months”

This is a very interesting statistic overall. Higher level athletes have a much lower re tear rate. In theory, a higher level athlete is more likely to adhere to a full sports centric rehab protocol. Also, genetically they are more likely gifted with a high than average work ethic. Return to sports being in the 6-13 ,month range is very interesting. Overall, it could range depending on many factors. Isolated ACL tears only occur in 10% of the population. Because of this, the co injuries could be of higher significance. Also, the sport involved changes the amount of time needed for a full recovery, albeit to a smaller degree.

This makes a great case for higher level and elite athletes to rehab for ACL reconstruction at a sports centric facility with sports centric rehab professionals. The rehabilitation of an ACL reconstruction is fairly straight forward for an average individual. For the high level athlete however, rehab is much more complicated. Body type, age, sport, co morbidities, prior injuries, strength and balance deficits all have a major player in how the body needs and responds to rehab. In a particular sport, the athlete’s position of play is also of the utmost importance. Different positions within a sport have many different needs. For example, a defensive back versus a running back, wide receiver vs quarter back, vs lineman. etc. They all have different needs. They all move differently. They all need specialized programs.

All rehab should be position, sports, and individual specific to the needs of the athlete. That what we do at CORE Physical Therapy and Sports Performance in Omaha.

This is who we are, this is what we do.

 

-Dr Mark Rathjen DPT, PT CSCS

 

 

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