Chelsey Roe1, Cale Jacobs2, Johanna Hoch3, Darren L Johnson2, Brian Noehren1. 1. Department of Physical Therapy, University of Kentucky, Lexington, Kentucky. 2. Department of Orthopedic Surgery & Sports Medicine, University of Kentucky, Lexington, Kentucky. 3. Department of Athletic Training and Clinical Nutrition, University of Kentucky, Lexington, Kentucky.
Abstract
CONTEXT: There is a lack of consensus regarding test batteries for return to sport (RTS) after anterior cruciate ligament reconstruction (ACLR). OBJECTIVE: To report the RTS test batteries for individuals after ACLR and to examine alignment with the American Academy of Orthopaedic Surgeons (AAOS) Appropriate Use Criteria (AUC). Finally, to examine how published RTS batteries prior to the AAOS AUC (2010-2015) compared with those after publication of the AUC (2016-2020). DATA SOURCE: A systematic search of PubMed (2010-2020). STUDY SELECTION: Studies were included if they were published from 2010 to 2020, patients underwent primary ACLR and were tested between 6 months and 2 years postoperatively and included a minimum of 2 assessments. Studies were excluded if patients were tested outside the designated time; had undergone a revision, contralateral, or multiligament injury; included healthy participants; were level 5 evidence or the study was a systematic review. A total of 1012 articles were reviewed and 63 met the criteria. STUDY DESIGN: Systematic review. LEVEL OF EVIDENCE: Level 4. DATA EXTRACTION: Information regarding the RTS batteries and patient demographics were extracted from the included articles. RESULTS: A total of 63 studies met the inclusion and exclusion criteria (22 from 2010-2015 and 41 from 2016-2020). The most common RTS batteries included the hop test, quadriceps strength test, and patient-reported outcome measures. No study met all 7 AUC; the most common criteria met were functional skills (98.4%), followed by confidence (22.2%), then range of motion and knee stability (20.6%). CONCLUSION: The test batteries in the current literature show high variability and a lack of essential components necessary for RTS. No study met the AUC guidelines, suggesting a disconnect between recommended guidelines and clinical practice. Test battery research has expanded over the past decade; however, standardized, clinically applicable batteries that encompass all criteria are needed.
CONTEXT: There is a lack of consensus regarding test batteries for return to sport (RTS) after anterior cruciate ligament reconstruction (ACLR). OBJECTIVE: To report the RTS test batteries for individuals after ACLR and to examine alignment with the American Academy of Orthopaedic Surgeons (AAOS) Appropriate Use Criteria (AUC). Finally, to examine how published RTS batteries prior to the AAOS AUC (2010-2015) compared with those after publication of the AUC (2016-2020). DATA SOURCE: A systematic search of PubMed (2010-2020). STUDY SELECTION: Studies were included if they were published from 2010 to 2020, patients underwent primary ACLR and were tested between 6 months and 2 years postoperatively and included a minimum of 2 assessments. Studies were excluded if patients were tested outside the designated time; had undergone a revision, contralateral, or multiligament injury; included healthy participants; were level 5 evidence or the study was a systematic review. A total of 1012 articles were reviewed and 63 met the criteria. STUDY DESIGN: Systematic review. LEVEL OF EVIDENCE: Level 4. DATA EXTRACTION: Information regarding the RTS batteries and patient demographics were extracted from the included articles. RESULTS: A total of 63 studies met the inclusion and exclusion criteria (22 from 2010-2015 and 41 from 2016-2020). The most common RTS batteries included the hop test, quadriceps strength test, and patient-reported outcome measures. No study met all 7 AUC; the most common criteria met were functional skills (98.4%), followed by confidence (22.2%), then range of motion and knee stability (20.6%). CONCLUSION: The test batteries in the current literature show high variability and a lack of essential components necessary for RTS. No study met the AUC guidelines, suggesting a disconnect between recommended guidelines and clinical practice. Test battery research has expanded over the past decade; however, standardized, clinically applicable batteries that encompass all criteria are needed.
Entities:
Keywords:
anterior cruciate ligament; appropriate use criteria; return to sport; test batteries
Authors: J J Irrgang; A F Anderson; A L Boland; C D Harner; M Kurosaka; P Neyret; J C Richmond; K D Shelborne Journal: Am J Sports Med Date: 2001 Sep-Oct Impact factor: 6.202
Authors: Trevor A Lentz; Giorgio Zeppieri; Steven Z George; Susan M Tillman; Michael W Moser; Kevin W Farmer; Terese L Chmielewski Journal: Am J Sports Med Date: 2014-12-05 Impact factor: 6.202