gms | German Medical Science

Objectives: A multitude of individual, temporal, injury- and surgery-specific factors impact on functional capacity during the rehabilitation, return to sports (RTS), and re-injury prevention processes after anterior cruciate ligament (ACL) reconstruction. Considering their interaction and nesting to derive individual courses of functional abilities strategies after ACL reconstructions is helpful for the management of deficit-oriented function-based rehabilitation.

Methods: Longitudinal observational diagnosis study. Completely anonymised data were retrieved form a nationwide register (OPED GmbH, Valley, Germany). Patients with an acute unilateral ACL rupture, with or without concomitant ipsilateral knee injuries, and having passed an arthroscopically applied, anatomical reconstruction were included. Potential factors were age, gender/sex, time since reconstruction [days], time between injury and reconstruction [days], concomitant intra-articular injuries (isolated ACL tear, meniscal tear, lateral ligament, unhappy triad), graft type (hamstrings, patellar, or quadriceps tendon allograft), and pain during the measurement (visual analogue scale 0-10 cm). Repeated assessments of a comprehensive battery of classic functional RTS test were performed: Range of motion (Flexion [degrees], "Extension" [degrees]), kinesthesia (Angle reproduction error [degrees]), Dynamic Balance Composite score [cm] of the Y-Balance test), drop jumps (Knee displacement [cm]), Vertical hop (Hopping height [mm]), Speedy jumps (Duration [seconds]), Side hops (Number of hops [n]), single leg hop for distance (hopping distance [cm]).

Repeated measures mixed models investigated the impact and interaction of the potential predictors on the functional outcomes.

Results and Conclusion: Data from 1441 persons (age: mean 29.4, SD 11.8 years; 592 females and 849 males) were included. Several variables predicted the functional test values of the reconstructed (Table 1 [Tab. 1]) leg.

Estimates of the individual contributors. Only model-relevant estimators are shown (otherwise, the cells are empty). Significant contributors are highlighted in bold letters. The unimpaired leg was mostly influenced by sex, age, the time between injury and reconstruction, and time since reconstruction.

Numerous factors like time between injury and reconstruction, time since reconstruction, age, gender, pain, graft type, and concomitant injuries contribute to the individual courses of functional abilities after ACL reconstruction. Knowing them and knowing their contribution value is helpful for the management of deficit-oriented function-based rehabilitation and individualised RTS strategies.