Patient Perception of Return to Sport Level Following ACL Reconstruction with BTB Autograft is 85% or Less Upon Initial Return Back to Sports

Athletes undergoing anterior cruciate ligament reconstruction (ACLR) often aim to return to sport (RTS) at pre-injury levels. Our study examines perceived performance upon return to sport and return to occupation at one-year post ACLR in comparison to pre-injury levels. Patients were 15-43 years old, underwent primary ACLR with BTB-autograft (2016-2020), followed-up for at least one year, and completed pre- and post-operative surveys assessing athletic ability and perceived performance upon return to practice and competition. Knee pain during activity was evaluated alongside return to occupation when applicable. 85 patients met the inclusion criteria, revealing that patients averaged 4.9 weekly practice hours post-operatively compared to 8.6 hours pre-operatively. Cutting sport athletes returned to practice at 293.3 days (reporting 72.8% of their pre-injury level) and full competition at 315 days (82.7% of pre-injury level). Non-cutting athletes returned at 280.8 days (feeling 64.9% of pre-injury level) and competition at 311.7 days (reporting 85%). Out of 100 points (100 being most painful), patients ranked their knee pain as 10.8 for light jogging, 15.1 for high intensity jogging, and 16.4 with cutting moves. Return-to-work averaged 25.86 days for sedentary occupations (n=14), and 34.13 days for walking/standing occupational demands (n=8). Following ACLR using BTB autografts, patients return to cutting sports feeling less than 83% of their pre-injury level, while non-cutting sport patients feel less than 85% of their pre-injury level. Pre-injury perceived performance does not correlate with post-operative return to practice or competition. Sedentary occupations return to work sooner compared to those with consistent walking/standing occupational demands.