Functional Return-to-Sport Testing Demonstrates Inconsistency in Predicting Short-Term Outcomes Following Anterior Cruciate Ligament Reconstruction: A Systematic Review.

Autor:	Gill VS; Mayo Clinic Alix School of Medicine, Scottsdale, Arizona, U.S.A.. Electronic address: Gill.Vikram@mayo.edu., Tummala SV; Department of Orthopedic Surgery, Mayo Clinic, Arizona, U.S.A., Sullivan G; Mayo Clinic Alix School of Medicine, Scottsdale, Arizona, U.S.A., Han W; Mayo Clinic Alix School of Medicine, Scottsdale, Arizona, U.S.A., Haglin JM; Department of Orthopedic Surgery, Mayo Clinic, Arizona, U.S.A., Marks L; Division of Education, Department of Library Services, Mayo Clinic, Arizona, U.S.A., Tokish JM; Department of Orthopedic Surgery, Mayo Clinic, Arizona, U.S.A.
Jazyk:	angličtina
Zdroj:	Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association [Arthroscopy] 2024 Jul; Vol. 40 (7), pp. 2135-2151.e2. Date of Electronic Publication: 2024 Jan 11.
DOI:	10.1016/j.arthro.2023.12.032
Abstrakt:	Purpose: To systematically review the relationship between functional testing at the time of return to sport (RTS) and short-term outcomes, such as second anterior cruciate ligament (ACL) tear and return to a preinjury level of sport, among athletes who underwent anterior cruciate ligament reconstruction (ACLR). Methods: A systematic literature search was performed in MEDLINE, EMBASE, Scopus, and Web of Science to identify studies examining athletes who underwent functional RTS testing and were followed for at least 12 months following ACLR. Studies were screened by 2 reviewers. A standardized template was used to extract information regarding study characteristics, ACLR information, functional test results, and risk factors associated with retear or reduced RTS. Results: Of the 937 studies identified, 22 met the inclusion criteria. The average time between ACLR and RTS testing was 8.5 months. Single leg hop for distance performance had no association with retear risk in any study and no association with RTS rates in most studies. Quadriceps strength had conflicting results in relation to retear risk, whereas it had no relationship with RTS rates. Rates of reinjury and RTS were similar between patients who passed and did not pass combined hop and strength batteries. Asymmetric knee extension and hip moments, along with increased knee valgus and knee flexion angles, demonstrated increased risk of retear. Conclusions: Individual hop and strength tests that are often used in RTS protocols following ACLR may have limited and inconsistent value in predicting ACL reinjury and reduced RTS when used in isolation. Combined hop and strength test batteries also demonstrate low sensitivity and negative predictive value, highlighting conflicting evidence to suggest RTS testing algorithm superiority. Level of Evidence: Level IV, systematic review of Level I-IV studies. Competing Interests: Disclosures The authors report the following potential conflicts of interest or sources of funding: J.M.T. reports royalties or licenses, consulting fees, and payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from Arthrex; and leadership or fiduciary role in other board, society, committee or advocacy group, paid or unpaid: AANA (President), outside the submitted work. All other authors (V.S.G., S.V.T., G.S., W.H., J.M.H., L.M.) declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. Full ICMJE author disclosure forms are available for this article online, as supplementary material. (Copyright © 2024 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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