Return to Sport after ACL Reconstruction using Hamstring Tendon: Analyzing 51 Cases from Maltas Hospital in Dakar

Abstract

The anterior cruciate ligament (ACL) rupture is a frequent lesion in athletes. It is incompatible with the practice of high-level sport, especially pivot and contact-pivot ones. The purpose of the ACL reconstruction is to allow the athlete to resume the practice of same sport at the same level. The study involved 51 sports patients operated for ACL reconstruction at the Order of Malta’s Hospital center in Dakar during the period from 1 January 2011 to 31 May 2014. The average age of patients was 26.3 years with a male predominance (92.15%). These were professional athletes in 37.25%, amateur in 31.37%, and leisure in 31.37% of the cases. The sport was contact-pivot in 96.6% of the cases, mainly football. The objective functional evaluation was performed using the Lysholm-Tegner scale and laximetry using the GNRB arthrometer. The overall sporting recovery rate was 96% with 54.9% recovery in the same sport at the same level. Professional athletes were 42 times more likely to resume the same sport at the same level as amateurs. Recovery times were 4.7 months for line sports, 9.2 months for pivot / contact-pivot and 11.3 months for the resumption of competition. These delays were shorter for professionals with a return to pivot sport at 8 months. Apprehension and fear of a new injury were the main reason for sport's downtime or decline. Functional and anatomical results were good with a mean Lysholm score of 91% and a GNRB differential of 2.87. No independent factor was predictive of returning to sport at the same level. Returning to sports activity is very likely after an ACL ligamentoplasty, but the return to the same sport at the same level is more uncertain, in the order of 55% despite satisfactory anatomical and functional results, confirming the important role of other factors such as psychological coaching and sport-specific rehabilitation.