This is a must read study published back in June 2016 on the above-mentioned topic. It is the Delaware-Oslo cohort study where they looked at 106 ACLR patients who participated in pivoting sports for a 2 year period prospectively.
Published online: 16 June 2016
“Results: Patients who returned to level I sports had a 4.32 (p=0.048) times higher reinjury rate than those who did not. The reinjury rate was significantly reduced by 51% for each month RTS was delayed until 9 months after surgery, after which no further risk reduction was observed. 38.2% of those who failed RTS criteria suffered reinjuries versus 5.6% of those who passed (HR 0.16, p=0.075). More symmetrical quadriceps strength prior to return significantly reduced the knee reinjury rate.”
“Conclusions: Returning to level I sports after ACL reconstruction leads to a more than 4-fold increase in reinjury rates over 2 years. RTS 9 months or later after surgery and more symmetrical quadriceps strength prior to return substantially reduce the reinjury rate.”
This was the study that showed that delaying RTS showed lower reinjury rates, a 50% reduction for each month RTS was delayed until the 9 months point. This perhaps questions the biological readiness of the ACL graft and does pose the question whether accelerated RTS poses an added reinjury risk. This is the balance of RTS that needs to be taken into account, despite meeting RTS criteria, which we now know from a few studies that it significantly reduces re-injury rates.
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