Influence of pre-surgery characteristics and sports practice level on return to sport after ACL reconstruction

Abstract

Objectives 1) To compare pre-surgery characteristics, pre-injury sports level, and 6-month recovery outcomes between patients with successful (sRTS) and unsuccessful (noRTS) return to sport at 24 months post-ACLR; 2) To identify whether pre-surgical characteristics or pre-injury sports level predict noRTS. Design Longitudinal cohort study. Participants 40 patients with ACLR. Main outcome measures Pre-surgery characteristics were collected and the level of sports practice was assessed using Tegner and Marx questionnaires, and the Noyes Sports Activity Rating Scale (NSARS). At 6 months a second evaluation was conducted. At 24 months, patients were divided into two groups: sRTS and noRTS. Results Pre-injury NSARS score was higher in noRTS (92.5 [80; 100]) compared to sRTS group (85 [72.5; 86.2]; p = 0.03). The multivariate model that best predicts noRTS (AUC = 0.83; p = 0.011) combines a higher pre-injury NSARS (AOR = 1.07 [1.01–1.14]; p = 0.001), more associated injuries (AOR = 1.55 [0.98–2.42]; p = 0.043), and longer injury to surgery time interval (AOR = 1.15 [0.91–1.46]; p = 0.21). Conclusion Clinicians should consider key risk factors (e.g. high pre-injury NSARS score, multiple associated injuries, delayed surgery) to tailor rehabilitation and improve return to pre-injury sports level 24 months post-ACLR.