Betsch Marcel, Darwich Ali, Chang Justin, Whelan Daniel, Ogilvie-Harris Darrell, Chahal Jaskarndip, Theodoropoulos John
Department of Orthopedics and Trauma Surgery, University Medical Center Mannheim of the University Heidelberg, Mannheim, Germany.
University of Toronto Orthopedic Sports Medicine Program (UTOSM), Women's College Hospital, Toronto, Ontario, Canada.
Arthrosc Sports Med Rehabil. 2022 Aug 15;4(5):e1759-e1766. doi: 10.1016/j.asmr.2022.07.001. eCollection 2022 Oct.
The purpose of this study is to explore currently used readiness to return to sport (RTS) criteria after anterior cruciate ligament reconstruction (ACLR) used in elite athletes to gain novel insights into the RTS decision-making process of professional team physicians.
Eighteen qualitative semistructured interviews with professional team physicians were conducted by a single trained interviewer. The interviews were used to identify team physician concepts and themes regarding the criteria used to determine RTS after ACLR. General inductive analysis and a coding process were used to identify themes and subthemes arising from the data. A hierarchical approach in coding helped to link themes.
The most important RTS criteria included muscle strength, followed by satisfactory functional testing including hop tests, a satisfactory clinical examination, joint stability, psychological readiness, time since the ACLR surgery, absence of joint effusion, subjective feeling of knee stability, pain-free return to sporting movements, completion of a sport-specific rehabilitation, and at last allied team support.
This study identified 4 main themes, including (1) objective findings, (2) informative feedback of the team members, (3) subjective findings, and (4) type of sport and time to surgery as having the most influence on RTS decision after ACLR. However, interviews showed that even among professional team physicians, the main criteria to RTS in these categories were inconsistent. A definitive set of conclusive guidelines could not be established and would be a fruitful and useful area for future research through further quantitative studies and international consensus meetings along the foundation of the presenting study.
V, evidence-based practices, qualitative study.
本研究旨在探讨目前精英运动员前交叉韧带重建（ACLR）后用于评估恢复运动（RTS）准备情况的标准，以深入了解职业队医在RTS决策过程中的新见解。
由一名经过培训的访谈者对18名职业队医进行了定性半结构化访谈。这些访谈用于确定队医关于ACLR后确定RTS标准的概念和主题。采用一般归纳分析和编码过程来识别数据中出现的主题和子主题。编码中的分层方法有助于将主题联系起来。
最重要的RTS标准包括肌肉力量，其次是令人满意的功能测试，包括单腿跳测试、令人满意的临床检查、关节稳定性、心理准备、ACLR手术后的时间、无关节积液、膝盖稳定性的主观感觉、无痛恢复运动、完成特定运动的康复，最后是团队支持。
本研究确定了4个主要主题，包括（1）客观发现，（2）团队成员的信息反馈，（3）主观发现，以及（4）运动类型和手术时间对ACLR后RTS决策影响最大。然而，访谈表明，即使在职业队医中，这些类别中RTS的主要标准也不一致。无法建立一套明确的结论性指南，通过在本研究基础上进行进一步的定量研究和国际共识会议，这将是未来研究的一个富有成果和有用的领域。
V，循证实践，定性研究。
