Patient-based decision for resuming activity after ACL reconstruction: a single-centre experience

• Published in: European journal of orthopaedic surgery & traumatology 2016-12, Vol.26 (8), p.929-935
• Main Authors: Jenny, Jean-Yves, Clement, Xavier
• Format: Article
• Language: English
• Subjects: Adult; Anterior Cruciate Ligament Injuries - surgery; Anterior Cruciate Ligament Reconstruction - methods; Anterior Cruciate Ligament Reconstruction - rehabilitation; Decision Making; Female; France; Humans; Knee Injuries - surgery; Male; Medicine; Medicine & Public Health; Original Article • KNEE - SPORT; Patients; Postoperative Complications - prevention & control; Recovery of Function; Retrospective Studies; Return to Sport - psychology; Return to Sport - statistics & numerical data; Return to Work - psychology; Return to Work - statistics & numerical data; Rupture - etiology; Rupture - prevention & control; Surgical Orthopedics; Time Factors; Traumatic Surgery; Treatment Outcome
• ISSN: 1633-8065; 1432-1068
• DOI: 10.1007/s00590-016-1861-0

Purpose The purpose of the study was to report the functional outcome following anterior cruciate ligament (ACL) reconstruction in patients who decide when to resume work and normal sporting activity post-operatively. The hypothesis tested was that patient-based decision to return to work and sport was possible without compromising functional outcome and increased the rate of repeat rupture in comparison with the existing literature. Methods This was a monocentric, retrospective study. Seventy-two patients requiring primary ACL reconstruction were included. All patients were followed up for a mean period of 4.3 years. Return to work and to sporting activity was allowed based on patient’s decision. No restriction was suggested by the physician. Delays to return to work and sports and occurrence of graft failure were documented. Results Sixty-six patients (92 %) returned to any sporting activity. The mean delay was 4.1 months for running, 6.1 months for pivoting sports, and 6.6 months for contact sports. Return to competitive sport was possible in 82 % of patients after a mean delay of 7.1 months. Return to work was possible for 96 % of patients after a mean delay of 2.3 months. Index Tegner score normalized in 71 % of patients. Four repeat ruptures (6 %) were observed, all of them following a significant knee injury. Conclusions Patient-based decision to return to work and sport was possible without compromising functional outcome. The post-operative restrictions implemented by orthopaedic surgeons following ACL reconstructions may be relaxed and more patient based.