Understanding Return to Sport Factors Following Anterior Cruciate Ligament Reconstruction: A Mixed-Methods Study

Anterior cruciate ligament reconstruction (ACLR) is thought to be the most relied upon method for regaining function and returning athletes to pre-injury activity levels following ACL injury. Outcomes after ACLR suggest athletes have returned to a level of function that would support return-to-sport; however, a recent meta-analysis reported pooled return rates of only 44% (Arden et al.) It is unclear whether this discrepancy is a result of functional impairments or whether there are underlying psychosocial factors influencing return-to-sport after ACLR. The purpose of this study is to comprehensively examine and explore physical and psychosocial factors that influence return-to-play decisions following ACLR. This will be a concurrent triangulation mixed methods design comparing participants that returned-to-sport with participants that did not return-to-sport. Participants (n~=40) a minimum of two years post-ACLR who have and have not returned-to-sport will be recruited from an existing ACL registry. Functional outcome measures will include isokinetic quadriceps/hamstring strength, single-leg hop tests, SEBT, step-down test, and self-report IKDC. A purposefully selected subsample will participate in semi-structured interviews. Results will provide information regarding the current functional outcomes and psychosocial factors following ACLR. This will allow clinicians to provide both physical and psychosocial support during rehabilitation to make a successful return-to-sport.