Likelihood of ACL graft rupture: not meeting six clinical discharge criteria before return to sport is associated with a four times greater risk of rupture

This must be one of the top 10 papers last year, according to Karim Khan it has to date more than 25k views.

Published online: 15 July 2016

Open-access: Yes

This is a must read for those who treat ACL patients. This study was done at Aspetar who looked 158 ACLR professional athletes who returned to their previous level.

A battery of 6 discharge criteria was used and followed to see its association with risk of ACL graft rupture after RTS. These 6 are:

  1. Isokinetic strength testing at 60°, 180° and 300°/s for quads
  2. Isokinetic strength testing at 60°, 180° and 300°/s for hams
  3. Running t test
  4. Single hop test
  5. Triple hop test
  6. Triple crossover hop test

“Results: Of the 158 athletes, 26 (16.5%) sustained an ACL graft rupture an average of 105 days after RTS. Two factors were associated with increased risk of ACL graft rupture: (1) not meeting all six of the discharge criteria before returning to team training (HR 4.1, 95% CI 1.9 to 9.2, p≤0.001); and (2) decreased hamstring to quadriceps ratio of the involved leg at 60°/s (HR 10.6 per 10% difference, 95% CI 10.2 to 11, p=0.005).”

 

“Conclusions Athletes who did not meet the discharge criteria before returning to professional sport had a four times greater risk of sustaining an ACL graft rupture compared with those who met all six RTS criteria. In addition, hamstring to quadriceps strength ratio deficits were associated with an increased risk of an ACL graft rupture.”

So from this study we can clearly see the benefit of using a battery of discharge criteria for RTS for ACLR patients. Hamstring strength also seems to be an indicator especially when we look at hams to quads ratio.

Please click on the link below to access the full text article.

Kyritsis, P. et al (2016) Likelihood of ACL graft rupture: not meeting six clinical discharge criteria before return to sport is associated with a four times greater risk of rupture. BJSM

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One thought on “Likelihood of ACL graft rupture: not meeting six clinical discharge criteria before return to sport is associated with a four times greater risk of rupture

  1. Pingback: Evidence-based clinical practice update: practice guidelines for ACL rehabilitation based on a systematic review and multidisciplinary consensus | Physio Research to Practice

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