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Quadriceps Strength Deficit at 6 Months After ACL Reconstruction Does Not Predict Return to Preinjury Sports Level

BACKGROUND: There is a lack of literature-based objective criteria for return to sport after anterior cruciate ligament (ACL) injury. Establishing such objective criteria is crucial to improving return to sport after ACL reconstruction (ACLR). HYPOTHESES: Patients who return to their preinjury level...

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Autores principales: Novaretti, João Victor, Franciozi, Carlos Eduardo, Forgas, Andrea, Sasaki, Pedro Henrique, Ingham, Sheila Jean McNeill, Abdalla, Rene Jorge
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5958456/
https://www.ncbi.nlm.nih.gov/pubmed/29485941
http://dx.doi.org/10.1177/1941738118759911
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author Novaretti, João Victor
Franciozi, Carlos Eduardo
Forgas, Andrea
Sasaki, Pedro Henrique
Ingham, Sheila Jean McNeill
Abdalla, Rene Jorge
author_facet Novaretti, João Victor
Franciozi, Carlos Eduardo
Forgas, Andrea
Sasaki, Pedro Henrique
Ingham, Sheila Jean McNeill
Abdalla, Rene Jorge
author_sort Novaretti, João Victor
collection PubMed
description BACKGROUND: There is a lack of literature-based objective criteria for return to sport after anterior cruciate ligament (ACL) injury. Establishing such objective criteria is crucial to improving return to sport after ACL reconstruction (ACLR). HYPOTHESES: Patients who return to their preinjury level of sport will have higher isokinetic, postural stability, and drop vertical jump test scores 6 months after surgery and greater patient satisfaction compared with those who did not. Additionally, quadriceps strength deficit cutoff values of 80% and 90% would differentiate patients who returned to preinjury sports level from those who did not. STUDY DESIGN: Cohort study. LEVEL OF EVIDENCE: Level 3. METHODS: A retrospective search was conducted to identify all patients who underwent ACLR and completed isokinetic evaluation, postural stability analysis, and drop vertical jump testing at 6 months postoperatively. Patients were asked to complete 3 questionnaires at a minimum 1 year after surgery. Chi-square and logistic regression analyses were used for categorical dependent variables, while the Student t test, Pearson correlation, or analyses of variance with Bonferroni post hoc testing were used for continuous dependent variables. A post hoc power analysis was completed. Based on the results regarding correlations between return to preinjury level and all other variables, effect sizes from 0.24 to 3.03 were calculated. With these effect sizes, an alpha of 0.05 and sample size of 58, a power ranging from 0.15 to 0.94 was calculated. RESULTS: The rates of return to preinjury level and to any sports activity were 53.4% and 84.4%. Those who were able to return to their preinjury level of sport (n = 33) showed significantly higher Lysholm (91.6 ± 9.7 vs 76.7 ± 15.4) and International Knee Documentation Committee (IKDC) (83.6 ± 10.6 vs 69.8 ± 14.6) values compared with those who were unable to return to their preinjury level of sport (n = 25) (P < 0.001). No significant differences were found for the clinical evaluations between those who were and those who were not able to return at the same level for the clinical evaluations (isokinetic evaluation, postural stability, drop vertical jump test) (P > 0.05). No significant differences were found when comparing quadriceps strength deficit with cutoff values of 80% and 90% for return to preinjury activity level (Tegner), Lysholm, and IKDC scores. CONCLUSION: Quadriceps strength deficit, regardless of cutoff value (80% or 90%), at 6 months after ACLR does not predict return to preinjury level of sport. Patients who returned to sport at their preinjury level were more satisfied with their reconstruction compared with those who did not. CLINICAL RELEVANCE: Quadriceps strength deficit is not a reliable predictor of return to sports, and therefore it should not be used as the single criterion in such evaluations.
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spelling pubmed-59584562019-02-27 Quadriceps Strength Deficit at 6 Months After ACL Reconstruction Does Not Predict Return to Preinjury Sports Level Novaretti, João Victor Franciozi, Carlos Eduardo Forgas, Andrea Sasaki, Pedro Henrique Ingham, Sheila Jean McNeill Abdalla, Rene Jorge Sports Health Current Research BACKGROUND: There is a lack of literature-based objective criteria for return to sport after anterior cruciate ligament (ACL) injury. Establishing such objective criteria is crucial to improving return to sport after ACL reconstruction (ACLR). HYPOTHESES: Patients who return to their preinjury level of sport will have higher isokinetic, postural stability, and drop vertical jump test scores 6 months after surgery and greater patient satisfaction compared with those who did not. Additionally, quadriceps strength deficit cutoff values of 80% and 90% would differentiate patients who returned to preinjury sports level from those who did not. STUDY DESIGN: Cohort study. LEVEL OF EVIDENCE: Level 3. METHODS: A retrospective search was conducted to identify all patients who underwent ACLR and completed isokinetic evaluation, postural stability analysis, and drop vertical jump testing at 6 months postoperatively. Patients were asked to complete 3 questionnaires at a minimum 1 year after surgery. Chi-square and logistic regression analyses were used for categorical dependent variables, while the Student t test, Pearson correlation, or analyses of variance with Bonferroni post hoc testing were used for continuous dependent variables. A post hoc power analysis was completed. Based on the results regarding correlations between return to preinjury level and all other variables, effect sizes from 0.24 to 3.03 were calculated. With these effect sizes, an alpha of 0.05 and sample size of 58, a power ranging from 0.15 to 0.94 was calculated. RESULTS: The rates of return to preinjury level and to any sports activity were 53.4% and 84.4%. Those who were able to return to their preinjury level of sport (n = 33) showed significantly higher Lysholm (91.6 ± 9.7 vs 76.7 ± 15.4) and International Knee Documentation Committee (IKDC) (83.6 ± 10.6 vs 69.8 ± 14.6) values compared with those who were unable to return to their preinjury level of sport (n = 25) (P < 0.001). No significant differences were found for the clinical evaluations between those who were and those who were not able to return at the same level for the clinical evaluations (isokinetic evaluation, postural stability, drop vertical jump test) (P > 0.05). No significant differences were found when comparing quadriceps strength deficit with cutoff values of 80% and 90% for return to preinjury activity level (Tegner), Lysholm, and IKDC scores. CONCLUSION: Quadriceps strength deficit, regardless of cutoff value (80% or 90%), at 6 months after ACLR does not predict return to preinjury level of sport. Patients who returned to sport at their preinjury level were more satisfied with their reconstruction compared with those who did not. CLINICAL RELEVANCE: Quadriceps strength deficit is not a reliable predictor of return to sports, and therefore it should not be used as the single criterion in such evaluations. SAGE Publications 2018-02-27 /pmc/articles/PMC5958456/ /pubmed/29485941 http://dx.doi.org/10.1177/1941738118759911 Text en © 2018 The Author(s)
spellingShingle Current Research
Novaretti, João Victor
Franciozi, Carlos Eduardo
Forgas, Andrea
Sasaki, Pedro Henrique
Ingham, Sheila Jean McNeill
Abdalla, Rene Jorge
Quadriceps Strength Deficit at 6 Months After ACL Reconstruction Does Not Predict Return to Preinjury Sports Level
title Quadriceps Strength Deficit at 6 Months After ACL Reconstruction Does Not Predict Return to Preinjury Sports Level
title_full Quadriceps Strength Deficit at 6 Months After ACL Reconstruction Does Not Predict Return to Preinjury Sports Level
title_fullStr Quadriceps Strength Deficit at 6 Months After ACL Reconstruction Does Not Predict Return to Preinjury Sports Level
title_full_unstemmed Quadriceps Strength Deficit at 6 Months After ACL Reconstruction Does Not Predict Return to Preinjury Sports Level
title_short Quadriceps Strength Deficit at 6 Months After ACL Reconstruction Does Not Predict Return to Preinjury Sports Level
title_sort quadriceps strength deficit at 6 months after acl reconstruction does not predict return to preinjury sports level
topic Current Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5958456/
https://www.ncbi.nlm.nih.gov/pubmed/29485941
http://dx.doi.org/10.1177/1941738118759911
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