Anterior cruciate ligament (ACL) rupture is one of the most common sports-related injuries to the knee.The ability to return to participation at the preinjury level is a key milestone in successful outcome after ACL reconstruction. Many athletes with apparently good knee function do not return to their preinjury level of sport.
The aim of this study was to investigate the rate of return to preinjury level of activity and causes of failure in Anterior Cruciate Ligament (ACL) reconstructed patients rehabilitated in our clinic.
41 patients (mean age 30 ± 8,7); 19 recreative, 22 competitive athletes participated in the study. A self-report questionnaire was used to collect data at 1-3 years after ACL reconstruction, regarding the level of athletic activity, reason of failure to return to sport and subjective knee function by Lysholm Knee Scoring Scale (LKSS).
17 (41,4%) of the patients were able to return to preinjury level of athletic activity. 11 of them were competitive (50% of competitive athletes), 6 were recreative athletes (31,5% of recreative athletes). Among 24 athletes who failed to return to preinjury level of athletic activity reported the cause of failure as; 10 (41,7%) feeling of weakness and insufficiency, 9 (37,5%) fear of reinjury and 5 (20,8%) self-decision. Mean LKSS score of patients returned to preinjury level of activity were 97,2, whereas the score for noncompliers were 90,3.
An important objective of anterior cruciate ligament (ACL) reconstruction is to enable patients to return to their preinjury sport or recreational activity. Objective physical recovery and returning to the preinjury sport and recreational activity may not necessarily coincide after ACL reconstruction, which raises the question of what other factors could impact on returning.
Clinical decision making for return to sports after ACL reconstruction is a challenging process.
Return to sport rates to pre-injury level of activity after ACL reconstructions are poor.
There was no significant correlation between LKSS scores and return to preinjury level of activity in this study.
There is growing evidence to suggest that psychological factors matter and this may have important implications for clinical practice. Majority of the patients participated in this study also remarked fear of reinjury and feeling of weakness and insufficiency to return athletic activities.
Postoperative rehabilitation programmes could be warranted to improve the rate of return to sport and recreational activities.
The reasons of failure to return to athletic activity are mostly found to be subjective and psychological. Additional research is needed to identify objective criteria and a setting of functional testing to detect the appropriate phase to return to sport besides a well-structured functional rehabilitation program to improve clinical decision making for return to sports after ACL reconstruction.
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