Psychological, physical and social factors influence decision to return to sport after revision ACL reconstruction with BPTB graft

Purpose There is limited evidence in literature regarding the patient-reported factors that influence their return to sport (RTS) in revision anterior cruciate ligament reconstruction (ACLR). The medium-term results of a prospective consecutive cohort of patients undergoing single- and two-stage revision ACLR with bone patellar tendon bone graft (BPTB) and patient-reported factors that influence their decision to return to sport are presented in this study. Methods Seventy-two patients were included in this prospective study. Single- or two-stage revision with BPTB graft was performed based on pre-operative planning. Iliac crest bone graft was used. Pre-operative and follow-up Lysholm and Tegner activity scores and RTS, level of sport and patient-reported factors affecting RTS were recorded. The mean follow-up was 9 years (SD 2.7 years). Results Single-stage revision ACLR was performed in 61 patients. In 11 patients (15%), revision ACLR was performed in two stages. There was a significant improvement in Lysholm score from mean 51.1 to 86.7 (p < 0.001). The incidence of re-rupture in this cohort was 0%. The median Tegner score was 6 (range 2–9). Twenty-five patients (34.7%) did not return to any sport at final follow-up. Twenty-nine (40.2%) patients returned to their pre-injury level of sport. Fear of reinjury (79%, p < 0.001) and persistent knee symptoms (35.8%, p = 0.03) were the most common factors limiting RTS in non-returners. Conclusion Psychological and social factors may have an influence on RTS in addition to physical factors.

Citation

Kiran, M., Javed, O., Roy, S., Atwal, N., & Gosal, H. (2022). Psychological, physical and social factors influence decision to return to sport after revision ACL reconstruction with BPTB graft. Knee surgery, sports traumatology, arthroscopy, 30(4), 1336-1340.

DOI

10.1007/s00167-021-06582-z

URI

https://hdl.handle.net/20.500.14709/899