Marom Niv, Xiang William, Wolfe Isabel, Jivanelli Bridget, Williams Riley J, Marx Robert G
Department of Orthopaedic Surgery, Meir Medical Center, 59 Tcharnihovsky St., 4428164, Kfar Saba, Israel.
The Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Knee Surg Sports Traumatol Arthrosc. 2022 Apr;30(4):1369-1379. doi: 10.1007/s00167-021-06594-9. Epub 2021 May 12.
Return to sport (RTS) after ACL reconstruction (ACLR) has been recognized as an important outcome, which is associated with success of the surgery. This study aimed to assess the methods used to determine return to sport after ACLR in the published literature, report on variability of methods and evaluate their strength in establishing accurate RTS data.
Electronic databases (PubMed, Cochrane Library and Embase) were searched via a defined search strategy with no limits, to identify relevant studies from January 2008 to December 2020 for inclusion in the review. Defined eligibility criteria included studies specifically measuring and reporting on return to sport after ACLR with a clear methodology. Each included study was assessed for the definition of successful RTS, successful return to pre-injury level of sport and for methods used to determine RTS.
One hundred and seventy-one studies were included. Of the included studies, six studies (4%) were level of evidence 1 and seventy-two studies (42%) were level of evidence 4. Forty-one studies (24%) reported on return to a specific sport and 130 studies (76%) reported on return to multiple sports or general sport. Sixteen studies (9%) reported on RTS in the pediatric population, 36 (21%) in the adult population and 119 (70%) reported on a mixed-aged population. The most commonly used definition of successful RTS was return to the same sport (44 of 125 studies, 35%). The most common method used to determine RTS was a non-validated study-specific questionnaire (73 studies, 43%), which was administered in various ways to the patients. Time of RTS assessment was variable and ranged between 6 months and 27 years post-surgery.
This review demonstrates high variability in defining, evaluating and reporting RTS following ACLR. The findings of this study reveal low reliability and unproven validity of methods used to evaluate RTS and highlight the challenges in interpreting and using RTS data reported in literature.
IV.
前交叉韧带重建术（ACLR）后恢复运动（RTS）已被视为一项重要的预后指标，与手术成功相关。本研究旨在评估已发表文献中用于确定ACLR后恢复运动的方法，报告方法的变异性，并评估其在建立准确的RTS数据方面的优势。
通过既定的检索策略对电子数据库（PubMed、Cochrane图书馆和Embase）进行无限制检索，以识别2008年1月至2020年12月期间的相关研究纳入综述。既定的纳入标准包括专门测量并报告ACLR后恢复运动且方法明确的研究。对每项纳入研究评估成功RTS的定义、成功恢复到伤前运动水平以及用于确定RTS的方法。
纳入171项研究。在纳入的研究中，6项研究（4%）为证据等级1，72项研究（42%）为证据等级4。41项研究（24%）报告了恢复到特定运动，130项研究（76%）报告了恢复到多项运动或一般运动。16项研究（9%）报告了儿科人群的RTS，36项（21%）报告了成人人群的RTS，119项（70%）报告了混合年龄人群的RTS。成功RTS最常用的定义是恢复到同一项运动（125项研究中的44项，35%）。用于确定RTS最常用的方法是未经验证的特定研究问卷（73项研究，43%），该问卷以多种方式施用于患者。RTS评估时间各不相同，范围在术后6个月至27年之间。
本综述表明，ACLR后在定义、评估和报告RTS方面存在高度变异性。本研究结果显示，用于评估RTS的方法可靠性低且有效性未经证实，并突出了在解释和使用文献中报告的RTS数据方面的挑战。
IV级。
