Passing return‐to‐sport criteria and landing biomechanics in young athletes following anterior cruciate ligament reconstruction. Issue 1 (17th June 2021)

• Record Type: Journal Article
• Authors: Losciale, Justin M.; Ithurburn, Matthew P.; Paterno, Mark V.; Schmitt, Laura C.
• Is Part Of: Journal of orthopaedic research. Volume 40:Issue 1(2022)
• Page Start: 208
• Page End: 218
• Publication Date: 2021-06-17
• Subjects: ACL reconstruction -- biomechanics -- joint loading -- kinematics -- kinetics -- return‐to‐sport criteria; Orthopedics -- Periodicals; Musculoskeletal system -- Periodicals; 616.7
• DOI: 10.1002/jor.25110
• Languages: English
• ISSNs: 0736-0266

Abstract

Abstract: We sought to evaluate the sagittal plane knee joint loading patterns during a double‐leg landing task among young athletes who passed or failed return‐to‐sport (RTS) criteria following anterior cruciate ligament reconstruction reconstruction (ACLR), and in uninjured athletes. Participants completed quadriceps strength testing, a hop test battery, and the International Knee Documentation Committee subjective form following medical RTS clearance. ACLR participants "passed" RTS criteria (RTS‐PASS) if they met ≥90 limb symmetry (%) or score on all measures and were categorized as "failing" (RTS‐FAIL) if not. All participants completed three‐dimensional motion analysis testing. Sagittal plane kinematic and kinetic variables were calculated during a double‐leg drop vertical jump task. Mean limb values and limb symmetry indices (LSI; %) were calculated and compared using a one‐way analysis of variance (ANOVA) (for LSI) and mixed between‐within ANOVA (for group × limb differences). A total of 205 participants were included, with 39 in the RTS‐PASS group, 109 in the RTS‐FAIL group, and 57 control groups (CTRLs). The RTS‐FAIL group demonstrated lower symmetry values for peak vertical ground reaction force, peak internal knee extension moment, and peak knee flexion angle. Group × limb interactions were observed for peak vertical ground reaction force and peak internal knee extension moment. Involved limb values were reduced in the RTS‐PASS and RTS‐FAIL groups compared to CTRLs, while the RTS‐PASS groups had lower uninvolved limb values compared to the RTS‐FAIL and CTRLs. Clinical Significance: Young athletes who pass RTS criteria after ACLR land symmetrically during a double‐leg task, but symmetry was achieved by reducing loading on both limbs.