Clinical course and recommendations for patients after anterior cruciate ligament injury and subsequent reconstruction: A narrative review

[摘要] Athletes who wish to resume high-level activities after an injury to the anterior cruciate ligament (ACL) are often advised to undergo surgical reconstruction.1,2 Patients’ general expectations after ACL reconstruction (ACLR) are high, with 94% expecting a return to sports (RTS) to the same level as before the injury.3 In addition, 98% of patients expected no, or only a slight increased, risk of developing osteoarthritis (OA) either after primary ACLR or revision surgery.3 These expectations are in sharp contrast to the findings of a recent systematic review and meta-analysis, indicating that only 65% of athletes after ACLR returned to the pre-injury level of sport and 55% returned to a competitive sports level.4 Another area of great concern is the incidence of OA with degenerative changes reported as early as two years after the initial ACL injury.5 Moreover, second ACL injuries (re-tearing either the ACL graft or the contralateral ACL) have gained more attention, given the reported rates of 15%.6 For young athletes (< 25 years) returning to competitive sports involving jumping and cutting activities, second ACL injury rates of 23% have been reported, especially in the early RTS period.

[学科分类] 神经科学

[关键词] anterior cruciate ligament injury;pre-operative rehabilitation;post-operative care;post-operative rehabilitation;psychological factors;return to sports;evaluation tools;time of return to sports