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Functional outcomes and return to sport following anterior cruciate ligament reconstruction in recreational athletes: A systematic review

Brzeszczynski, Filip; Turnbull, Kirsten; McClelland, Colin; MacDonald, Donnie; Lawson, Graham; Hamilton, David


Filip Brzeszczynski

Kirsten Turnbull

Donnie MacDonald

Graham Lawson

David Hamilton


Outcomes of anterior cruciate ligament reconstruction (ACLR) are well reported in athletic populations, however surprisingly little information is available for the recreational athletes that make up the majority of cases. The aim was therefore to assess post-operative outcome and return-to-sport in recreational athletes following ACLR.

A systematic search was conducted in Ovid MEDLINE, CINAHL, AMED and the grey literature according to PRISMA guidelines. Studies involving a clear definition of recreational athletes who underwent ACLR and recorded postoperative outcomes were included. Publication quality was assessed using Newcastle-Ottawa Scale.

107 studies were identified, 19 full-text records reviewed and 13 included, reflecting 1342 patients with an average age of 31.7 (SD 9.8) years. Mean follow-up was 43.6 (SD 42.8) months. Activity change post-surgery was reported in 92% (12/13) papers. Outcomes were assessed with the Tegner score in seven studies, four of which reported pre-injury scores, which worsened from 5.4 to 4.3 at final follow-up (76.5 months). 54% (7/13) studies reported return to pre-injury level of sport. In these, 59% (n = 327/555) achieved pre-injury level at a mean follow-up of 33.7 months (SD 38.6). The return-to-sports rate increased with length of follow-up. Methodological quality was moderate.

Substantial variation in the timeframes and outcomes assessed restricts pooled analysis of change in function. Based on seven studies, 59% of recreational athletes return to pre-injury level of sport following ACLR. The link between return rate and post-operative review timeframe suggests that longer follow-up may be required to capture return-to-sport rates in this population.

Journal Article Type Article
Acceptance Date Apr 20, 2022
Online Publication Date May 13, 2022
Publication Date 2022-06
Deposit Date Apr 27, 2022
Journal The Knee
Print ISSN 0968-0160
Publisher Elsevier
Peer Reviewed Peer Reviewed
Volume 36
Pages 103-113
Public URL