Strategic clinical decision-making after ACL injury and reconstruction: patient reported outcome measures, return to sport, second injury prevention, and predictors of osteoarthritis
Date
2020
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Publisher
University of Delaware
Abstract
Anterior cruciate ligament (ACL) reconstruction (ACLR) is the common treatment recommendation after ACL injury, however, outcomes after surgery are not uniformly good. Only about 55% of athletes return to previous levels of competition after ACLR and among those who do return, up to 30% have a second ACL injury. Additionally, patients with ACL injury have higher rates of osteoarthritis, some as early as one year after injury. ACL injury is a common sport injury with increasing incidence, and a peak age between 15-25 years old, so these injuries have devastating consequences to both activities of daily living and sports participation in young active individuals. ☐ The long-term objective of this work is to improve clinical decision-making to increase return to sport rate, reduce second injuries, and reduce incidence of early OA after ACL injury. This project will measure responsiveness of four commonly used PROMs (Aim 1), identify biomechanical risk factors for loss of medial compartment tibiofemoral joint space width (Aim 2), evaluate the effect of a specialized intervention on second injury rate (Aim 3), and the timing of intervention on second injury and return to sport rates (Aim 4) to achieve this goal,. The goal of this work is to inform clinical decision-making regarding outcome measures, timing of visits, second injury risk, and identification for progression of radiographic knee osteoarthritis in patients after an ACL injury/reconstruction.
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Keywords
Anterior cruciate ligament, Athlete, Injury prevention, Osteoarthritis, Rehabilitation, Return to sport