The majority of athletes fail to return to play following anterior cruciate ligament reconstruction due to reasons other than the operated knee

• Published in: Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA sports traumatology, arthroscopy : official journal of the ESSKA, 2021-11, Vol.29 (11), p.3877-3882
• Main Authors: Toale, James P., Hurley, Eoghan T., Hughes, Andrew J., Withers, Daniel, King, Enda, Jackson, Mark, Moran, Ray
• Format: Article
• Language: English
• Subjects: Anterior cruciate ligament; Athletes; Fear; Knee; Ligaments; Medicine; Medicine & Public Health; Orthopedics; Pain; Psychological assessment; Psychological factors; Sports Medicine
• ISSN: 0942-2056; 1433-7347
• DOI: 10.1007/s00167-020-06407-5

Purpose The purpose of this study is to evaluate the reasons why athletes do not return to play (RTP) following anterior cruciate ligament (ACL) reconstruction from a large single-centre database. Methods The institutional ACL registry was screened for patients that had undergone a primary ACLR and had RTP status reported at 24-month follow-up. The reasons that patients were unable to RTP at 24 months were evaluated. The ACL-Return to Sport Index (ACL-RSI) was evaluated at baseline and 24-month follow-up to evaluate psychological ability to RTP. Results At 2 years, 1140 patients returned to play, and 222 had not returned to play. The most common reasons athletes were unable to return was fear of reinjury (27.5%), lack of confidence in performance on return (19.4%) and external life factors (16.6%), i.e. work commitments and family reasons. Other reasons for athletes not returning to play were residual knee pain (10%) and subsequent injury (5%). The ACL-RSI score was significantly lower at diagnosis (40.3 vs. 49.3; p  = 0.003) and 2 years (41.8 vs. 78.7; p