Relationships Between Patient-Reported Outcomes and Return to Sport Assessments in Adolescent Patients Following...

Psychological health effects after anterior cruciate ligament (ACL) reconstruction is of interest, with perceived poor health thought to negatively impact recovery. Understanding the relationship between perceived health at mid-rehabilitation and objective outcomes at return to sport will help clinicians ensure that rehabilitation meets the specific needs of patients.

A retrospective chart review.

A chart review of 44 adolescent patients (n = 22 males, 50%) who presented for ACL reconstruction from March 2020 to March 2022 was conducted. Patients completed the ACL-Return to Sport Index Short Form and Pediatric International Knee Documentation Committee form during mid-rehabilitation evaluation (average 5.7 [0.73] mo postsurgery) and performed strength and functional testing during the return to sport evaluation (average 9.1 [1.6] mo postsurgery). Outcome variables included absolute and relative bodyweight peak torque knee extension and peak torque knee flexion, limb symmetry index, single-leg hop for distance, and 30-second side hop.

Higher Pediatric International Knee Documentation Committee scores at mid-rehabilitation were correlated with higher peak torque (r = .369, P < .05) and higher peak torque/BW (r = .527, P < .05) during knee extension on the operative leg and better knee extension limb symmetry index (r = .381, P < .05) at return to sport testing. Higher Pediatric International Knee Documentation Committee scores mid-rehabilitation were correlated with a lower hamstring-to-quadriceps ratio on the operative leg (r = -.373, P < .05) at return to sport testing. Higher ACL-Return to Sport Index Short Form scores mid-rehabilitation were correlated with lower 30-second side-hop repetitions on the operative (r = -.480, P < .05) and nonoperative (r = .456, P < .05) legs.

These correlations suggest that patient-reported outcomes during mid-rehabilitation may correlate to strength and functional outcomes at return to sport. In addition, biases may exist between patient-reported outcomes, patient sex, and strength and functional measures. The unexpected finding that readiness to return to sport correlated with lower repetitive jumping performance requires further study.