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One year might not be enough to return to sport after ACL reconstruction - patient and surgical predictors of return to sport based on 272 patients with data from two registers
ESSKA Academy. Hamrin Senorski E. May 12, 2018; 218115
Dr. Eric Hamrin Senorski
Dr. Eric Hamrin Senorski
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Abstract
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Objectives: To study whether patient characteristics, concomitant injuries and graft choice at primary ACL reconstruction can predict a return to sport one year after surgery. The hypothesis was that patients without concomitant injuries would have a greater likelihood of returning to sport.

Methods: Data were extracted from a rehabilitation-specific register and the Swedish National Knee Ligament Register. Twelve months after surgery, all patients were evaluated for a return to sport using the Tegner activity scale. The primary outcome was a return to knee-strenuous sport, defined as a Tegner activity scale of ≥ 6. Univariable and multivariable logistic regression analyses were performed with patient characteristics, concomitant knee injuries and graft choice as independent variables.

Results: A total of 272 patients (50.7% females) with an average age of 25.0 ± 9.2 years were included. In the multivariable analysis, a favorable odds ratio (OR) for returning to sport was found in patients of male sex (OR=2.58 [95% CI; 1.43-4.65], p=0.0016), younger age at the time of ACL reconstruction (OR=2.32 [95% CI; 1.59-3.33], p<0.0001), a higher pre-injury score on the Tegner activity scale (OR=1.45 ([95% CI; 1.13-1.87], p=0.0038) and an absence of injury to the meniscus (OR=1.92 ([95% CI; 1.10-3.36], p=0.023) and medial collateral ligament (MCL) OR=7.61 ([95% CI; 1.42-40.87], p=0.018). In addition, the absence of cartilage injury was favorable in terms of a return to sport in the univariable analysis, OR=2.48 ([95% CI; 1.40-4.39], p=0.0018).

Conclusions: Positive predictors of a return to knee-strenuous sport one year after ACL reconstruction were male gender, younger age, a high pre-injury level of physical activity and the absence of concomitant injuries to the MCL, meniscus and cartilage.

Keywords:
Anterior cruciate ligament, ACL, register, return to sport, sport
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