The Relationship between Patient-Reported Outcome Measures and Return-to-Play Assessments in Patients Post-Anterior Cruciate Ligament Surgical Reconstruction

Document Type

Poster

Abstract

Background: Psychosocial health effects on post-operative recovery is of interest, with perceived poor health thought to negatively impact recovery trajectories. Understanding the relationship between patient-perceived health mid-rehabilitation and objective outcomes at return-to-sport (RTS) will help clinicians ensure rehabilitation meets the specific needs of patients. Hypothesis/Purpose: The purpose of this study was to determine the relationship between mid-rehabilitation patient-report of health and RTS assessments in anterior cruciate ligament reconstruction (ACL-R) patients. Study Design: Retrospective Chart Review Methods: A review of patients who presented to a pediatric hospital for ACL-R from March 2020-March 2022 was conducted using CPT codes 27429 and 29888. Patients were included if they were age 11-21 at time of surgery and completed mid-rehabilitation and RTS assessments. Patients completed the ACL-Return-to-Sport Index Short Form (ACL-RSI SF) and Pediatric International Knee Documentation Committee (Pedi-IKDC) form during mid-rehabilitation evaluation (average 5.7±.73 months post-surgery) and performed strength and functional testing during the RTS evaluation (average 9.1±1.6 months post-surgery). Outcome variables included absolute peak torque knee extension, absolute peak torque knee flexion, limb symmetry index (LSI), single leg hop for distance, and 30-second side hop tests. Pearson correlations (r) were used to estimate the strength of association between patient-reported scores at mid-rehabilitation with strength and function outcome variables during RTS evaluation. Significance was set at p<.05. Results: 44 patients were included in analysis. Patients were male (50%, n=22) and female (50%, n=22) and averaged 15.5±1.48 years old. Higher Pedi-IKDC scores at mid-rehabilitation were predictive of higher peak torque during knee extension on the operative leg (r=.37, p<0.05) and better knee extension LSI (r=.38, p<0.05) at RTS testing. Higher Pedi-IKDC scores mid-rehabilitation were predictive of a lower hamstring-to-quadriceps ratio on the operative leg (r=-0.37, p<0.05) at RTS testing. Higher ACL-RSI SF scores mid-rehabilitation were predictive of lower 30-second side hop repetitions on the operative (r=-0.48, p<0.05) and non-operative (r=0.46, p<0.05) legs. Conclusion: These correlations suggest that self-report of health, function, and readiness to return-to-sport midway through rehabilitation help anticipate strength and functional outcomes at return-to-sport. The unexpected finding that readiness to return-to-sport predicts lower repetitive jumping performance needs further study.

Publication Date

Fall 2023

Comments

Poster presented at ATSU-ASHS DAT Fall - 2023. is a Kubify based presentation hosted at https://api.ltb.io/show/ABXYF It includes a video presentation, references, a PowerPoint presentation, and summary poster.

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