TABLE 1.
PATIENT CHARACTERISTICS
| Return to Sport Rate (%) | Variables Associated with Return to Sport |
Variables Not Associated with Return to Sport |
|||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Literature | Level of Evidence [57]/Risk of Bias [55] |
Total Patients | Mean Age (Years) | Graft Type | Pre-Injury Athletic Participation |
Patient Follow-up | Pre-Injury Level | Modified Level | Did Not Return |
Knee Impairment or Functional |
Psychological | Knee Impairment or Functional |
Psychological |
| Overall | 1574 (67% M/ 33% F) | 27.3 * | 378 PT/ 867 HS/ 329 NR ¥ | 50.7 | 32.9 | 17.2 | |||||||
| Ardern et al.[58] | 4 / High | 503 (68% M / 32% F) | 27.2 | 503 HS | Competitive | 1 year | 33.4 | 33.6 | 33.0 | LSI ≥ 85% hop tests |
- | IKDC Grade | - |
| Arvidsson et al[59] |
4 / High | 87 (97% M / 3% F) |
25.3 | 87 PT | NR | 7.9 years | 25.3 | 66.7 | 8.0 | Higher quadriceps torque |
- | Hamstring torque | - |
| Baltaci et al.[61] |
4 / High | 15 (gender NR) | 29.6 | NR | Recreational | 1.5–2 years | NR | NR | NR | Faster 6 meter shuttle run test, higher hamstring torque |
- | LSI on hop tests, Lysholm Knee Score, Step hop test, Vertical Jump, 10 step climb test |
- |
| Barrett et al.[60] | 4 /High | 45 (73% M/ 27% F) |
26.4 | 45 PT | Competitive and recreational |
3 years | 53.3 | 31.1 | 15.6 | Lower knee effusion and pain |
- | Anterior knee laxity | - |
| Gobbi et al.[63] | 2 / High | 60 (67% M/33% F) |
30.4* | 60 HS | At least recreational |
1,2,3 years | 100 | 0 | 0 | - | Higher pre-operative psychovitality |
- | - |
| Gobbi et al.[62] | 4 /High | 100 (67% M/ 33% F) |
28 | 50 PT / 50 HS |
At least recreational |
2 years | 65.0 | 24.0 | 11.0 | Higher Marx Activity Score |
Higher pre-operative psychovitality |
Lysholm Knee Score, IKDC subjective form score, IKDC Grade |
- |
| Heijne et al.[64] | 2 / High | 64 (55% M/45% F) |
30.1 | 32 PT / 32 HS |
NR | 1 year | NR | NR | NR | Higher pre-operative quadriceps torque |
- | Pre-operative knee extension ROM, pre-operative anterior knee laxity, pre-injury sports activity level |
- |
| Kvist et al.[48] | 4 / High | 62 (55% M/45% F) |
27 | 55 PT / 7 HS |
NR | 3–4 years | 53.0 | NR | NR | - | Lower TSK score | - | - |
| Langford et al.[68] |
4 / High | 87 (63% M/37% F) |
27.5 | 4 PT / 83 HS |
Competitive | 6 months; 1 year |
51.0 | NR | NR | - | Higher ACL-RSI | LSI on hop tests, postoperative anterior knee laxity |
ERAIQ |
| Lee DY et al.[6] |
4 / High | 64 (95% M/5% F) | 24.8 | 64 HS | Competitive and recreational |
5 years | 43.8 | 26.5 | 29.7 | Higher Lysholm Knee Score, higher IKDC subjective form score, IKDC Grade A&B |
- | - | - |
| Lee S et al.[67] |
2 / High | 42 (88% M/12% F) |
30.3* | 42 HS | NR | 2 years | NR | NR | NR | Higher postoperative tibial IR, ER, and total rotation at 0 degrees of knee extension |
- | - | - |
| Lentz et al.[69] |
2 / High | 94 (64% M/36% F) |
22.4 | PT and HS | At least recreational |
1 year | 55.0 | NR | NR | Lower knee effusion, fewer episodes of instability, lower pain, higher quadriceps torque-body weight ratio, higher IKDC subjective form score |
Lower TSK score | Postoperative anterior knee laxity, postoperative knee extension and flexion ROM, LSI quadriceps strength |
- |
| Mikkelsen et al.[70] |
4 / High | 44 (77% M/23% F) |
24.1* | 44 PT | Recreational (1 no participation) |
2.5 years | 38.6 | 52.3 | 9.1 | Higher quadriceps torque |
- | - | - |
| Thomeé et al.[49] |
2 / High | 38 (66% M/34% F) |
29.7 | 12 PT/26 HS | At least recreational |
1 year | NR | NR | NR | - | Higher pre-operative K-SES |
- | - |
| Tripp et al.[65] |
2 / High | 49 (55% M/45% F) |
29.2 | 49 PT | At least recreational |
1 year | NR | NR | NR | - | Lower TSK score | - | Negative affect, catastrophizing |
| Webster et al.[66] |
2 / High | 220 (56% M/44%F) |
29.2 | NR | At least recreational |
1 year | 39.5 | 29.1 | 31.4 | - | Higher ACL-RSI | - | - |
M = Male; F = Female; PT = patellar tendon; HS = hamstring tendon; NR = not reported; LSI = limb symmetry index; OKC = open kinetic chain; CKC = closed kinetic chain; ROM = range of motion; IKDC = International Knee Documentation Committee; TSK = Tampa Scale of Kinesiophobia; ACL-RSI = Anterior Cruciate Ligament-Return to Sport after Injury Scale; ERAIQ = Emotional Responses of Athletes to Injury Questionnaire; K-SES = Knee Self Efficacy Scale; IR = internal rotation; ER = external rotation;
weighted mean age
The Overall “NR” in the Graft Type column includes the 94 patients in the Lentz et al.[68] study, as specific numbers for patients with each graft type were not provided.
Return to pre-injury sport defined as patients achieving the same activity level or same sport post-surgery as their pre-injury activity level. Modified sports activity defined as patients achieving a lesser activity level as compared to their pre-injury activity level. No return to sport defined as patients unable to participate in any athletic activity.