Low proportion of skeletally immature patients met return-to-sports criteria at 7 Months following ACL reconstruction

• Published in: Physical therapy in sport 2020-07, Vol.44, p.143-150
• Main Authors: Sugimoto, Dai, Heyworth, Benton E., Carpenito, Sara C., Davis, Farren W., Kocher, Mininder S., Micheli, Lyle J.
• Format: Article
• Language: English
• Subjects: Age; Injury prevention; Knee; Ligaments; Medical prognosis; Pediatric; Pediatrics; Physical therapy; Population; Prognosis; Rehabilitation; Return to play; Sports medicine; Studies; Surgery; Youth athletes
• ISSN: 1466-853X; 1873-1600
• DOI: 10.1016/j.ptsp.2020.05.007

To examine the proportion of skeletally immature anterior cruciate ligament reconstructed (ACLR) patients who achieve ≥90% of lower extremity recovery at 6–9 months post-operatively. Cross-sectional study. Biomechanical laboratory. Skeletally immature ACLR patients. Muscular strength (quadriceps, hamstrings, hip abductors, and hip extensors), dynamic balance (anterior reach, posteromedial reach, and posterolateral reach), and functional hops tests (single hop, triple hops, cross-over hops, and 6 m timed hops) were examined. The primary outcome variable was the proportion of the study patients whose limb symmetry index (LSI) were ≥90% during return to sport (RTS) tests. A total of 105 skeletally immature ACLR patients who are planning to return to sporting activities (age: 13.4 ± 1.4 years) were enrolled. The proportion of skeletally immature ACLR patients who achieved ≥90% of LSI in all four strength, three balance, and four hop tests were 20.0%, 65.4%, and 27.8%. In those who completed all test battery (72/105), only 4.2% of skeletally immature ACLR patients demonstrated ≥90% of LSI in all RTS tests. A small proportion of skeletally immature ACLR patients demonstrated ≥90% of lower extremity recovery approximately at 7 months following ACLR. •Proportion of skeletally immature ACLR patients who achieve ≥90% of LSI in four muscular strength tests (quadriceps, hamstrings, hip abductors, hip extensors) was only 20% at 7 months following ACLR surgery.•65% of skeletally immature ACLR patients reached ≥90% of LSI in three directions (anterior reach, posteromedial reach, posterolateral reach) of balance test in 7 months post surgically.•28% of skeletally immature ACLR patients performed ≥90% of LSI in four hop tests (single hop, triple hops, cross-over hops, and 6 meter timed hops) after 7 months from ACLR surgery.•In sum, only 4% of skeletally immature ACLR patients demonstrated ≥90% of LSI in all (four muscular strength, three balance, four hop tests) return to sport tests at 7 months post-ACLR surgery.