A comparison of return to sport measures following ACL reconstruction in patients with and without postoperative complications.

Background: Current return to sport guidelines following anterior cruciate ligament reconstruction (ACLR) are based on studies focusing on patients with primary and isolated anterior cruciate ligament (ACL) injuries. This study aims to investigate return to sport measures in a population of patients who underwent ACLR with post-operative complications and compare these outcomes to patients who underwent ACLR without complications.

Methods: The study screened 788 patients following ACLR and included data from 13 participants who suffered a post-operative complication and matched these participants with those who underwent primary, unilateral ACLR without complication. Complications included cyclops lesion (6), infection (2), fracture (1), wound dehiscence (1), Arthrofibrosis (1), DVT (1) and loose body leading to mechanical symptoms (1). Limb Symmetry Index (LSI) was calculated from strength and hop testing at scheduled post-operative visits. Patient reported outcome measures (PROMs), including the International Knee Documentation Committee (IKDC) and the Knee Injury and Osteoarthritis Outcome Score (KOOS), were collected.

Results: The two groups did not differ in age, height, or mass. There were no significant differences in any strength or hop test variables and the groups reported similar function via PROMs when controlling for graft type and time post-surgery.

Conclusion: There were no differences in LSI and PROMs between patients who underwent ACLR with postoperative complications and patients without complications. This suggests that patients who have complications following ACLR are not necessarily at increased risk for delayed limb strength recovery or worse patient-reported outcomes compared to patients with uncomplicated ACLR at approximately 8.5 months following ACLR.