Evidence map›Paper›PMID 33978778›Full record

SynthesisKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2022

High variability and lack of standardization in the evaluation of return to sport after ACL reconstruction: a systematic review.

Niv Marom, William Xiang, Isabel Wolfe, Bridget Jivanelli, Riley J Williams, Robert G Marx

Abstract readSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
19citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

19 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Asymmetry in Recreational Athletes One Year After Anterior Cruciate Ligament Reconstruction: Comparison of Isokinetic Strength and Hop Test Performance.Physiotherapy research international : the journal for researchers and clinicians in physical therapy · 2026
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Niv MaromDepartment of Orthopaedic Surgery, Meir Medical Center, 59 Tcharnihovsky St., 4428164, Kfar Saba, Israel. niv.marom@gmail.com.ORCID http://orcid.org/0000-0001-5393-6134
William XiangWeill Cornell Medical College, New York, NY, USA.
Isabel WolfeSports Medicine Institute, Hospital for Special Surgery, New York, NY, USA.
Bridget JivanelliHospital for Special Surgery, Kim Barrett Memorial Library, New York, NY, USA.
Riley J WilliamsSports Medicine Institute, Hospital for Special Surgery, New York, NY, USA.
Robert G MarxSports Medicine Institute, Hospital for Special Surgery, New York, NY, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeReturn to sport (RTS) after ACL reconstruction (ACLR) has been recognized as an important outcome, which is associated with success of the surgery. This study aimed to assess the methods used to determine return to sport after ACLR in the published literature, report on variability of methods and evaluate their strength in establishing accurate RTS data.

methodsElectronic databases (PubMed, Cochrane Library and Embase) were searched via a defined search strategy with no limits, to identify relevant studies from January 2008 to December 2020 for inclusion in the review. Defined eligibility criteria included studies specifically measuring and reporting on return to sport after ACLR with a clear methodology. Each included study was assessed for the definition of successful RTS, successful return to pre-injury level of sport and for methods used to determine RTS.

resultsOne hundred and seventy-one studies were included. Of the included studies, six studies (4%) were level of evidence 1 and seventy-two studies (42%) were level of evidence 4. Forty-one studies (24%) reported on return to a specific sport and 130 studies (76%) reported on return to multiple sports or general sport. Sixteen studies (9%) reported on RTS in the pediatric population, 36 (21%) in the adult population and 119 (70%) reported on a mixed-aged population. The most commonly used definition of successful RTS was return to the same sport (44 of 125 studies, 35%). The most common method used to determine RTS was a non-validated study-specific questionnaire (73 studies, 43%), which was administered in various ways to the patients. Time of RTS assessment was variable and ranged between 6 months and 27 years post-surgery.

conclusionThis review demonstrates high variability in defining, evaluating and reporting RTS following ACLR. The findings of this study reveal low reliability and unproven validity of methods used to evaluate RTS and highlight the challenges in interpreting and using RTS data reported in literature. LEVEL OF EVIDENCE: IV.

Indexed as

Anterior Cruciate Ligament InjuriesAnterior Cruciate Ligament ReconstructionAdultAgedChildHumansReference StandardsReproducibility of ResultsReturn to SportACL reconstructionEvaluation of return to sportMethodologyOutcomesPatient reported outcomesReturn to playReturn to sport

Identifiers

PMID33978778

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.