ESTIMATED PERFORMANCE FOR AGE: A NOVEL CRITERION FOR RETURN TO SPORT AFTER ANTERIOR CRUCIATE RECONSTRUCTION AND ITS PERFORMANCE COMPARED TO LIMB SYMMETRY INDICES. Issue 7 (30th July 2021)
- Record Type:
- Journal Article
- Title:
- ESTIMATED PERFORMANCE FOR AGE: A NOVEL CRITERION FOR RETURN TO SPORT AFTER ANTERIOR CRUCIATE RECONSTRUCTION AND ITS PERFORMANCE COMPARED TO LIMB SYMMETRY INDICES. Issue 7 (30th July 2021)
- Main Title:
- ESTIMATED PERFORMANCE FOR AGE: A NOVEL CRITERION FOR RETURN TO SPORT AFTER ANTERIOR CRUCIATE RECONSTRUCTION AND ITS PERFORMANCE COMPARED TO LIMB SYMMETRY INDICES
- Authors:
- Magill, John
Vance, Danica
Risoli, Thomas
Green, Cynthia
Reinke, Emily
Reiman, Michael
Thorburg, Kristian
Riboh, Jonathan - Abstract:
- INTRODUCTION: The use of physical performance tests (PPT) for assessing readiness for return to sport (RTS) after ACL reconstruction in children is typically assessed based on a limb symmetry index (LSI). However, recent data show that: 1) healthy pediatric athletes have significant limb asymmetries at baseline and 2) the non-operative limb deconditions after ACLR, so return of LSI is not synonymous with return to pre-injury performance. We previously established a cohort of 100 healthy pediatric athletes and created growth curves for performance on 7 common PPT, allowing for the calculation of a performance percentile (PP) for any given individual based on their age. The current study explores the use of PP in a cohort of pediatric patients 6 months out from ACLR. We hypothesized that return to expected performance for age (EPFA, defined as the 50 th percentile of performance among healthy volunteers of a given age) would be a more stringent criterion than 90% LSI. METHODS: We performed a retrospective analysis of a prospective cohort of consecutive patients (< 19 years) undergoing ACL reconstruction between 2016-2019. Patients were excluded if they did not have RTS testing 6 months after surgery (+/- 6 weeks). RTS testing consisted of 7 PPT (Figure 1). Patients were then categorized into passing and failing groups based on two cutoffs: 1) LSI > 90% and 2) PP > EPFA (50 th percentile). The prevalence of passing based on these two criteria were compared using contingencyINTRODUCTION: The use of physical performance tests (PPT) for assessing readiness for return to sport (RTS) after ACL reconstruction in children is typically assessed based on a limb symmetry index (LSI). However, recent data show that: 1) healthy pediatric athletes have significant limb asymmetries at baseline and 2) the non-operative limb deconditions after ACLR, so return of LSI is not synonymous with return to pre-injury performance. We previously established a cohort of 100 healthy pediatric athletes and created growth curves for performance on 7 common PPT, allowing for the calculation of a performance percentile (PP) for any given individual based on their age. The current study explores the use of PP in a cohort of pediatric patients 6 months out from ACLR. We hypothesized that return to expected performance for age (EPFA, defined as the 50 th percentile of performance among healthy volunteers of a given age) would be a more stringent criterion than 90% LSI. METHODS: We performed a retrospective analysis of a prospective cohort of consecutive patients (< 19 years) undergoing ACL reconstruction between 2016-2019. Patients were excluded if they did not have RTS testing 6 months after surgery (+/- 6 weeks). RTS testing consisted of 7 PPT (Figure 1). Patients were then categorized into passing and failing groups based on two cutoffs: 1) LSI > 90% and 2) PP > EPFA (50 th percentile). The prevalence of passing based on these two criteria were compared using contingency analysis. A multivariable linear regression was performed to assess the effects of demographic variables on PP. RESULTS: Sixty-three patients were included (57% male, mean age 14.2 ± 2.4 years). Mean time from surgery to RTS testing was 181.5 ± 15.1 days. More patients were able to achieve 90% LSI than EPFA for all PPT except the timed hop (Figure 1). On average, 58% met LSI > 90% compared to only 41% meeting EPFA. Reaching 90% LSI correlated weakly with reaching EPFA for 4 of the 7 PPTs. However, of patients that would have passed based LSI, only 36.2-63.2% would have passed based on meeting EPFA (Figure 2). There was no consistent effect of age, sex, or graft type on PP. CONCLUSION: Six months after ACL reconstruction, fewer pediatric athletes can meet EPFA than can meet 90% LSI. Additionally, PP does not clearly correlate with LSI, suggesting that these criteria provide complementary information. Future studies investigating the use of EPFA as a cutoff for RTS are warranted. : Figure 1:. Prevalence of 50 th Performance Percentile and 90% Limb Symmetry Index (LSI) for each PPT Figure 2:. Prevalence of Above or Below the 50 th Performance Percentile for Patient that reached a passing LSI (90%). … (more)
- Is Part Of:
- Orthopaedic journal of sports medicine. Volume 9:Issue 7(2021)Supplement 3
- Journal:
- Orthopaedic journal of sports medicine
- Issue:
- Volume 9:Issue 7(2021)Supplement 3
- Issue Display:
- Volume 9, Issue 7, Part 3 (2021)
- Year:
- 2021
- Volume:
- 9
- Issue:
- 7
- Part:
- 3
- Issue Sort Value:
- 2021-0009-0007-0003
- Page Start:
- Page End:
- Publication Date:
- 2021-07-30
- Subjects:
- Sports medicine -- Periodicals
Orthopedics -- Periodicals
Arthroscopy -- Periodicals
Arthroplasty -- Periodicals
Knee -- Surgery -- Periodicals
616.7 - Journal URLs:
- http://www.sagepublications.com/ ↗
- DOI:
- 10.1177/2325967121S00130 ↗
- Languages:
- English
- ISSNs:
- 2325-9671
- Deposit Type:
- Legaldeposit
- View Content:
- Available online (eLD content is only available in our Reading Rooms) ↗
- Physical Locations:
- British Library DSC - BLDSS-3PM
British Library HMNTS - ELD Digital store - Ingest File:
- 19505.xml