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Defining Return to Sport: A Systematic Review.

Joshua Doege1, Jack M Ayres2, Matthew J Mackay2

  • 1Tulane University School of Medicine, New Orleans, Louisiana, USA.

Orthopaedic Journal of Sports Medicine
|August 11, 2021
PubMed
Summary

Return to sport (RTS) lacks a standard definition in orthopaedic surgery research. Most studies define RTS as competing in a game, but variations exist, highlighting the need for standardized terminology for better outcome assessment.

Keywords:
athletic trainingmedical aspect of sportsphysical therapy/rehabilitationreturn to playreturn to sport

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Area of Science:

  • Orthopaedic Sports Medicine
  • Clinical Outcomes Assessment
  • Surgical Research

Background:

  • Return to sport (RTS) is a common metric for clinical outcomes in orthopaedic sports medicine.
  • Currently, no universally accepted definition exists for when an athlete has officially returned to sport.
  • This lack of standardization hinders consistent research and outcome evaluation.

Purpose of the Study:

  • To systematically review and analyze the diverse definitions of Return to Sport (RTS) used in orthopaedic surgery literature.
  • To identify and report variations in RTS definitions across published studies.
  • To inform the development of standardized RTS criteria.

Main Methods:

  • Systematic review adhering to PRISMA guidelines.
  • Searches conducted in PubMed, EMBASE, and Cochrane Trials databases.
  • Analysis of recorded RTS definitions from eligible studies.

Main Results:

  • 29 studies provided a clear definition of RTS.
  • 69% defined RTS as competing in a game or competitive play.
  • Variations included competition-level modifiers (10.3%), return to training/practice (6.9%), and non-standard terminology (13.8%).

Conclusions:

  • Significant variability exists in the definition of RTS within orthopaedic sports medicine literature.
  • Most studies define RTS by competitive play, but other definitions are present.
  • Standardizing RTS definitions and incorporating terms like 'return to participation' and 'return to performance' is crucial for precise outcome assessment.