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After an anterior cruciate ligament (ACL)
rupture, the aim of the treatment (whatever the
treatment, conservative or surgical) is to allow
the patient to return to previous physical
activity. If the patient is sedentary, the
conservative treatment usually allows a safe
return to normal daily life. If the patient is an
athlete, the surgical treatment must be
considered especially if the practiced sport is a
pivot-sport. The aim of the surgical treatment
must be pointed out, mainly to provide a stable
knee in order to return to sport activity. There is
currently no evidence that surgery could
prevent osteoarthritis in comparison to
conservative treatment.
There is a consensus on clearance to return to
sport should occur at around 6 months after the
surgery, between 4 to 9 months for moderate
sports and at a range from 4 to 18 months in
case of strenuous sports [1]. However, there is
no real scientific evidence to define an accurate
time to return to sport.
The objective of this paper is to provide a
return to play guidelines after ACL re
construction, based on our experience and
supported by the current literature.
INTRODUCTION
One of the main and first question that an
athlete asks to his surgeon after an ACL rupture
is
“When can I go back to play?”
It is usually
observed in professional athlete population as
well the pressure from the club. The competition
calendar and the financial issues are prominent,
but it can be asked by a recreational athlete,
like some “weekend warriors” as the sport is an
important part of their life, physical and
psychological balance. The surgeon should
take in consideration these factors before
making any surgical decision and informing
the patient about the objective and the
timeframe of the surgery along with re
habilitation procedures accordingly, in order to
fit the patient’s expectation. Therefore, patient’s
information is crucial to avoid any
disappointment and any mistake in the
postoperative evolution.
The main questions for the surgeon are: When
is it safe to stress the graft according to the
bone integration and graft healing process?
When do patients have sufficient muscle
strength and neuromuscular control to cope
with the physical load of their sport? The two
RETURN TO PLAY
AFTER ACL RUPTURE
P. LANDREAU