The majority of athletes fail to return to play following anterior cruciate ligament reconstruction due to reasons other than the operated knee
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...
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| Veröffentlicht 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 |
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| container_title | Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA |
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| creator | Toale, James P. Hurley, Eoghan T. Hughes, Andrew J. Withers, Daniel King, Enda Jackson, Mark Moran, Ray |
| description | 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
|
| doi_str_mv | 10.1007/s00167-020-06407-5 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2482667565</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2482667565</sourcerecordid><originalsourceid>FETCH-LOGICAL-c375t-32f9f2929c49a8896230b6b9ca53dfd5af23c608550fc2fa627615d08e9c989d3</originalsourceid><addsrcrecordid>eNp9kc-OFCEQh4nRuOOuL-DBkHjx0m41NNAczcZ_ySZ7Wc-EoYuZHulmBDpmnsJXltleNfHgiUrx1VeEHyGvWnjXAqjrDNBK1QCDBmQHqhFPyKbtOG8U79RTsgHdsYaBkBfkRc4HgFp2-jm54FyA4pxtyM_7PdLJHmIay4lGT23ZByyYqbdjoCXShGVJ87k6BnuiPoYQf4zzjtq5YBpjoi4tbrQFaRh3dsK51BkX51xqv4xxpsOCq8nm2qax7DHRsrfVWrfHI6Y6PdBvM-IVeeZtyPjy8bwkXz9-uL_53Nzeffpy8_62cVyJ0nDmtWeaaddp2_daMg5budXOCj74QVjPuJPQCwHeMW8lU7IVA_Sone71wC_J29V7TPH7grmYacwOQ7AzxiUb1vVMSiWkqOibf9BDrD9SX2eY6FvZcsVlpdhKuRRzTujNMY2TTSfTgjnHZda4TI3LPMRlzurXj-plO-HwZ-R3PhXgK5Dr1bzD9Hf3f7S_AIpjoig</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2581613736</pqid></control><display><type>article</type><title>The majority of athletes fail to return to play following anterior cruciate ligament reconstruction due to reasons other than the operated knee</title><source>Wiley Online Library Journals Frontfile Complete</source><source>SpringerLink Journals - AutoHoldings</source><creator>Toale, James P. ; Hurley, Eoghan T. ; Hughes, Andrew J. ; Withers, Daniel ; King, Enda ; Jackson, Mark ; Moran, Ray</creator><creatorcontrib>Toale, James P. ; Hurley, Eoghan T. ; Hughes, Andrew J. ; Withers, Daniel ; King, Enda ; Jackson, Mark ; Moran, Ray</creatorcontrib><description>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
< 0.0001) in athletes who did not return to play vs. those that did RTP.
Conclusion
The majority of patients that report they have not returned to play do so due to external life and psychological factors associated with their injury, including fear of reinjury and lack of confidence in performance. A small minority of patients were unable to return due to residual knee symptoms or reinjury. Pre-operative psychological assessment and intervention may identify those less likely to RTP and provide an opportunity for targeted interventions to further improve RTP outcomes.
Level of evidence
III.</description><identifier>ISSN: 0942-2056</identifier><identifier>EISSN: 1433-7347</identifier><identifier>DOI: 10.1007/s00167-020-06407-5</identifier><identifier>PMID: 33507332</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Anterior cruciate ligament ; Athletes ; Fear ; Knee ; Ligaments ; Medicine ; Medicine & Public Health ; Orthopedics ; Pain ; Psychological assessment ; Psychological factors ; Sports Medicine</subject><ispartof>Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2021-11, Vol.29 (11), p.3877-3882</ispartof><rights>European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA) 2021</rights><rights>European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA) 2021.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c375t-32f9f2929c49a8896230b6b9ca53dfd5af23c608550fc2fa627615d08e9c989d3</citedby><cites>FETCH-LOGICAL-c375t-32f9f2929c49a8896230b6b9ca53dfd5af23c608550fc2fa627615d08e9c989d3</cites><orcidid>0000-0002-7696-2981</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00167-020-06407-5$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00167-020-06407-5$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33507332$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Toale, James P.</creatorcontrib><creatorcontrib>Hurley, Eoghan T.</creatorcontrib><creatorcontrib>Hughes, Andrew J.</creatorcontrib><creatorcontrib>Withers, Daniel</creatorcontrib><creatorcontrib>King, Enda</creatorcontrib><creatorcontrib>Jackson, Mark</creatorcontrib><creatorcontrib>Moran, Ray</creatorcontrib><title>The majority of athletes fail to return to play following anterior cruciate ligament reconstruction due to reasons other than the operated knee</title><title>Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA</title><addtitle>Knee Surg Sports Traumatol Arthrosc</addtitle><addtitle>Knee Surg Sports Traumatol Arthrosc</addtitle><description>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
< 0.0001) in athletes who did not return to play vs. those that did RTP.
Conclusion
The majority of patients that report they have not returned to play do so due to external life and psychological factors associated with their injury, including fear of reinjury and lack of confidence in performance. A small minority of patients were unable to return due to residual knee symptoms or reinjury. Pre-operative psychological assessment and intervention may identify those less likely to RTP and provide an opportunity for targeted interventions to further improve RTP outcomes.
Level of evidence
III.</description><subject>Anterior cruciate ligament</subject><subject>Athletes</subject><subject>Fear</subject><subject>Knee</subject><subject>Ligaments</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Orthopedics</subject><subject>Pain</subject><subject>Psychological assessment</subject><subject>Psychological factors</subject><subject>Sports Medicine</subject><issn>0942-2056</issn><issn>1433-7347</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp9kc-OFCEQh4nRuOOuL-DBkHjx0m41NNAczcZ_ySZ7Wc-EoYuZHulmBDpmnsJXltleNfHgiUrx1VeEHyGvWnjXAqjrDNBK1QCDBmQHqhFPyKbtOG8U79RTsgHdsYaBkBfkRc4HgFp2-jm54FyA4pxtyM_7PdLJHmIay4lGT23ZByyYqbdjoCXShGVJ87k6BnuiPoYQf4zzjtq5YBpjoi4tbrQFaRh3dsK51BkX51xqv4xxpsOCq8nm2qax7DHRsrfVWrfHI6Y6PdBvM-IVeeZtyPjy8bwkXz9-uL_53Nzeffpy8_62cVyJ0nDmtWeaaddp2_daMg5budXOCj74QVjPuJPQCwHeMW8lU7IVA_Sone71wC_J29V7TPH7grmYacwOQ7AzxiUb1vVMSiWkqOibf9BDrD9SX2eY6FvZcsVlpdhKuRRzTujNMY2TTSfTgjnHZda4TI3LPMRlzurXj-plO-HwZ-R3PhXgK5Dr1bzD9Hf3f7S_AIpjoig</recordid><startdate>20211101</startdate><enddate>20211101</enddate><creator>Toale, James P.</creator><creator>Hurley, Eoghan T.</creator><creator>Hughes, Andrew J.</creator><creator>Withers, Daniel</creator><creator>King, Enda</creator><creator>Jackson, Mark</creator><creator>Moran, Ray</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7RV</scope><scope>7TS</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-7696-2981</orcidid></search><sort><creationdate>20211101</creationdate><title>The majority of athletes fail to return to play following anterior cruciate ligament reconstruction due to reasons other than the operated knee</title><author>Toale, James P. ; Hurley, Eoghan T. ; Hughes, Andrew J. ; Withers, Daniel ; King, Enda ; Jackson, Mark ; Moran, Ray</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c375t-32f9f2929c49a8896230b6b9ca53dfd5af23c608550fc2fa627615d08e9c989d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Anterior cruciate ligament</topic><topic>Athletes</topic><topic>Fear</topic><topic>Knee</topic><topic>Ligaments</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Orthopedics</topic><topic>Pain</topic><topic>Psychological assessment</topic><topic>Psychological factors</topic><topic>Sports Medicine</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Toale, James P.</creatorcontrib><creatorcontrib>Hurley, Eoghan T.</creatorcontrib><creatorcontrib>Hughes, Andrew J.</creatorcontrib><creatorcontrib>Withers, Daniel</creatorcontrib><creatorcontrib>King, Enda</creatorcontrib><creatorcontrib>Jackson, Mark</creatorcontrib><creatorcontrib>Moran, Ray</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>Proquest Nursing & Allied Health Source</collection><collection>Physical Education Index</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Toale, James P.</au><au>Hurley, Eoghan T.</au><au>Hughes, Andrew J.</au><au>Withers, Daniel</au><au>King, Enda</au><au>Jackson, Mark</au><au>Moran, Ray</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The majority of athletes fail to return to play following anterior cruciate ligament reconstruction due to reasons other than the operated knee</atitle><jtitle>Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA</jtitle><stitle>Knee Surg Sports Traumatol Arthrosc</stitle><addtitle>Knee Surg Sports Traumatol Arthrosc</addtitle><date>2021-11-01</date><risdate>2021</risdate><volume>29</volume><issue>11</issue><spage>3877</spage><epage>3882</epage><pages>3877-3882</pages><issn>0942-2056</issn><eissn>1433-7347</eissn><abstract>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
< 0.0001) in athletes who did not return to play vs. those that did RTP.
Conclusion
The majority of patients that report they have not returned to play do so due to external life and psychological factors associated with their injury, including fear of reinjury and lack of confidence in performance. A small minority of patients were unable to return due to residual knee symptoms or reinjury. Pre-operative psychological assessment and intervention may identify those less likely to RTP and provide an opportunity for targeted interventions to further improve RTP outcomes.
Level of evidence
III.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>33507332</pmid><doi>10.1007/s00167-020-06407-5</doi><tpages>6</tpages><orcidid>https://orcid.org/0000-0002-7696-2981</orcidid></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0942-2056 |
| ispartof | Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2021-11, Vol.29 (11), p.3877-3882 |
| issn | 0942-2056 1433-7347 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2482667565 |
| source | Wiley Online Library Journals Frontfile Complete; SpringerLink Journals - AutoHoldings |
| subjects | Anterior cruciate ligament Athletes Fear Knee Ligaments Medicine Medicine & Public Health Orthopedics Pain Psychological assessment Psychological factors Sports Medicine |
| title | The majority of athletes fail to return to play following anterior cruciate ligament reconstruction due to reasons other than the operated knee |
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