Retorno ao esporte no nível pré-lesão após reconstrução do ligamento cruzado anterior: fatores preditores

Abstract

The anterior cruciate ligament (ACL) lesion is among the most prevalent knee conditions, causing several functional deficits. ACL reconstruction (ACLR) is a common procedure for returning to sports practice. Objectives: To verify the predictive factors of return to the sport at the same pre-injury level and their interactions in individuals who performed ACLR. Methodology: Cross-sectional study of 136 participants, with at least 6 months after ACLR. All participants answered the International Knee Documentation Committee (IKDC) and Anterior Cruciate Ligament - Return to Sport After Injury (ACL-RSI) questionnaires and performed a postural stability evaluation on the Biodex Balance System and strength of the quadriceps and hamstring muscles using the Isokinetic Dynamometer. The Classification and Regression Tree (CART) was used to establish a relation between the vectors of predictor variables and the response variable and the Odds Ratio to verify the probability of no return at preinjury level. Results: The strongest predictor variable was the ACL-RSI, with a cut grade of 72.85%. As secondary factors we obtained the overall stability index of the injured limb, limb symmetry index for extension and IKDC, with cut scores of 3.2º, 16.6% and 82.75% respectively. The model is able to verify in 60% of the times who cannot return, with a specificity of 97.4%. Conclusions: The psychological component, observed by ACL-RSI, is the most important predictor of return to sports at the preinjury level. Secondarily, we can consider overall stability of the injured limb, symmetric force for extension and function, reported by the IKDC.