Purpose
The purpose of this study is to explore currently used readiness to return to sport
(RTS) criteria after anterior cruciate ligament reconstruction (ACLR) used in elite
athletes to gain novel insights into the RTS decision-making process of professional
team physicians.
Methods
Eighteen qualitative semistructured interviews with professional team physicians were
conducted by a single trained interviewer. The interviews were used to identify team
physician concepts and themes regarding the criteria used to determine RTS after ACLR.
General inductive analysis and a coding process were used to identify themes and subthemes
arising from the data. A hierarchical approach in coding helped to link themes.
Results
The most important RTS criteria included muscle strength, followed by satisfactory
functional testing including hop tests, a satisfactory clinical examination, joint
stability, psychological readiness, time since the ACLR surgery, absence of joint
effusion, subjective feeling of knee stability, pain-free return to sporting movements,
completion of a sport-specific rehabilitation, and at last allied team support.
Conclusions
This study identified 4 main themes, including (1) objective findings, (2) informative
feedback of the team members, (3) subjective findings, and (4) type of sport and time
to surgery as having the most influence on RTS decision after ACLR. However, interviews
showed that even among professional team physicians, the main criteria to RTS in these
categories were inconsistent. A definitive set of conclusive guidelines could not
be established and would be a fruitful and useful area for future research through
further quantitative studies and international consensus meetings along the foundation
of the presenting study.
Level of Evidence
V, evidence-based practices, qualitative study.
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Article info
Publication history
Published online: August 15, 2022
Accepted:
July 1,
2022
Received in revised form:
June 22,
2022
Received:
March 16,
2022
Footnotes
M.B. and A.D. contributed equally.
The authors report that they have no conflicts of interest in the authorship and publication of this article. Full ICMJE author disclosure forms are available for this article online, as supplementary material.
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