Note: To access the video accompanying this report, visit the December issue of Arthroscopy at www.arthroscopyjournal.org.
Arthroscopy: The Journal of Arthroscopic & Related Surgery
Systemic Review With Video IllustrationFactors Used to Determine Return to Unrestricted Sports Activities After Anterior Cruciate Ligament Reconstruction
Section snippets
Literature Search
We searched Medline for all published literature from April 2001 to April 2011 using the following key words: anterior cruciate ligament reconstruction, ACL reconstruction, ACL reconstruction rehabilitation, and ACL reconstruction results. We also conducted manual searches of the following journals published during this time period: The American Journal of Sports Medicine; Arthroscopy; The Journal of Bone and Joint Surgery (both the American and British volumes); The Knee; Clinical Orthopaedics
Literature Search
Our search initially identified 716 articles, of which 452 were excluded according to our study criteria. This led to 264 articles appropriate for this review. Of these, 105 (40%) failed to provide any criteria for return to sports after ACL reconstruction (Fig 1). In the remaining 159 studies, 6 of the 9 categories of return-to-sports criteria that were searched for were found. The number of categories identified per study was 1 in 125 studies, 2 in 19 studies, 3 in 13 studies, 4 in 1 study,
Discussion
The primary findings of this systematic review suggest that noteworthy problems and a lack of objective assessment methods exist in the published literature before release to unrestricted sports activities after ACL reconstruction. Only 35 (13%) of the 264 articles reviewed included some measurable objective criteria that patients had to achieve before resuming unrestricted athletics. However, even in those articles, only 1 to 2 criteria other than time postoperatively were included in most of
Conclusions
The published literature shows that a lack of consensus regarding the appropriate criteria for releasing patients to unrestricted sports activities exists after ACL reconstruction. A systematic review of the literature was conducted to identify the factors investigators have used over the last 10 years to determine when return to athletics is appropriate. Of 264 studies that met our study inclusion criteria, 105 (40%) failed to provide any measures for return to sports after surgery. Only 35
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The authors report that they have no conflicts of interest in the authorship and publication of this article.