Relationships Between Patient-Reported Outcomes and Return to Sport Assessments in Adolescent Patients Following Anterior Cruciate Ligament Reconstruction

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CONTEXT: Psychological health effects after anterior cruciate ligament (ACL) reconstruction is of interest, with perceived poor health thought to negatively impact recovery. Understanding the relationship between perceived health at mid-rehabilitation and objective outcomes at return to sport will help clinicians ensure that rehabilitation meets the specific needs of patients. DESIGN: A retrospective chart review. METHODS: A chart review of 44 adolescent patients (n = 22 males, 50%) who presented for ACL reconstruction from March 2020 to March 2022 was conducted. Patients completed the ACL-Return to Sport Index Short Form and Pediatric International Knee Documentation Committee form during mid-rehabilitation evaluation (average 5.7 [0.73] mo postsurgery) and performed strength and functional testing during the return to sport evaluation (average 9.1 [1.6] mo postsurgery). Outcome variables included absolute and relative bodyweight peak torque knee extension and peak torque knee flexion, limb symmetry index, single-leg hop for distance, and 30-second side hop. RESULTS: Higher Pediatric International Knee Documentation Committee scores at mid-rehabilitation were correlated with higher peak torque (r = .369, P < .05) and higher peak torque/BW (r = .527, P < .05) during knee extension on the operative leg and better knee extension limb symmetry index (r = .381, P < .05) at return to sport testing. Higher Pediatric International Knee Documentation Committee scores mid-rehabilitation were correlated with a lower hamstring-to-quadriceps ratio on the operative leg (r = -.373, P < .05) at return to sport testing. Higher ACL-Return to Sport Index Short Form scores mid-rehabilitation were correlated with lower 30-second side-hop repetitions on the operative (r = -.480, P < .05) and nonoperative (r = .456, P < .05) legs. CONCLUSION: These correlations suggest that patient-reported outcomes during mid-rehabilitation may correlate to strength and functional outcomes at return to sport. In addition, biases may exist between patient-reported outcomes, patient sex, and strength and functional measures. The unexpected finding that readiness to return to sport correlated with lower repetitive jumping performance requires further study.

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