Patient-based decision for resuming activity after ACL reconstruction: a single-centre experience.
OBJECTIVE
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.
Centre de Chirurgie Orthopédique et de la Main, University Hospital, 10 Avenue Baumann, 67400, Strasbourg, Illkirch, France. jean-yves.jenny@chru-strasbourg.fr.
Jean-Yves
http://orcid.org/0000-0001-9146-9792
JY
Jenny
Centre de Chirurgie Orthopédique et de la Main, University Hospital, 10 Avenue Baumann, 67400, Strasbourg, Illkirch, France.
Xavier
X
Clement
D000328:Adult; D000070598:Anterior Cruciate Ligament Injuries / Q000601:surgery*; D059549:Anterior Cruciate Ligament Reconstruction / Q000379:methods / Q000534:rehabilitation; D003657:Decision Making; D005260:Female; D005602:France; D006801:Humans; D007718:Knee Injuries / Q000601:surgery; D008297:Male; D011183:Postoperative Complications / Q000517:prevention & control*; D020127:Recovery of Function; D012189:Retrospective Studies; D000068958:Return to Sport / Q000523:psychology / Q000706:statistics & numerical data; D062707:Return to Work / Q000523:psychology / Q000706:statistics & numerical data; D012421:Rupture / Q000209:etiology / Q000517:prevention & control; D013997:Time Factors; D016896:Treatment Outcome
Anterior cruciate ligament; Reconstruction; Return to sport; Return to work
Ann Phys Rehabil Med. 2010 Dec;53(10 ):598-614
21112824
Am J Sports Med. 2016 Apr;44(4):1069-79
25999439
Am J Sports Med. 2014 Oct;42(10 ):2319-28
25201444
J Bone Joint Surg Am. 2012 Oct 3;94(19):1737-48
23032584
Orthop Traumatol Surg Res. 2014 Sep;100(5):521-6
25082774
Health Qual Life Outcomes. 2003 Nov 03;1:64
14613558
Br J Sports Med. 2014 Mar;48(5):356-64
24124040
Knee Surg Sports Traumatol Arthrosc. 2010 Aug;18(8):1128-44
20069277
Arthroscopy. 2011 Dec;27(12 ):1697-705
22137326
Am J Sports Med. 2015 Sep;43(9):2164-74
26187130
Orthopedics. 2012 Oct;35(10 Suppl):18-21
23026247
Acta Orthop Scand. 1988 Jun;59(3):336-41
3381671
Orthop Traumatol Surg Res. 2011 Sep;97(5):555-9
21652276
Am J Sports Med. 2011 Nov;39(11):2476-83
21515806
Knee Surg Sports Traumatol Arthrosc. 2011 Aug;19(8):1299-306
21293848
Am J Sports Med. 2011 Dec;39(12):2536-48
21952714
Am J Sports Med. 1995 Sep-Oct;23 (5):575-9
8526273
Br J Sports Med. 2011 Jun;45(7):596-606
21398310
Am J Sports Med. 2001 Sep-Oct;29(5):600-13
11573919
Joints. 2015 Jun 08;3(1):25-30
26151036
J Sport Rehabil. 2014 May;23 (2):158-64
23981536