Rates of Return to Sport After Surgical Management of Multiligament Knee Injuries Are Higher Than Previously Described yet Highly Heterogeneous: A Systematic Review
To provide an updated overview of return to sport (RTS) and return to work (RTW) after surgical management of multiligament knee injuries (MLKIs). A search was conducted across the MEDLINE, Embase, and PubMed databases from inception to August 26, 2024. Studies published after 2018 that reported on...
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| Vydáno v: | Arthroscopy Ročník 41; číslo 11; s. 4911 |
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01.11.2025
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| ISSN: | 1526-3231 |
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| Abstract | To provide an updated overview of return to sport (RTS) and return to work (RTW) after surgical management of multiligament knee injuries (MLKIs).
A search was conducted across the MEDLINE, Embase, and PubMed databases from inception to August 26, 2024. Studies published after 2018 that reported on rates of RTS or RTW after multiligament knee reconstruction were included. Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines were followed, and a quality assessment was performed using the Methodological Index for Non-randomized Studies (MINORS) criteria. Data on study characteristics, demographic characteristics, and surgical details were extracted. Rates of RTS or RTW at the same level or at any level of participation were recorded. Random-effects models were used to generate forest plots.
Fifteen studies reported on RTS, with rates ranging from 41.2% to 100% when investigating RTS at any level. Thirteen studies reported rates of return to preinjury level, ranging from 5.9% to 100%. RTS rates at any level and preinjury level had higher ceilings than shown in a prior systematic review. Time taken to RTS ranged from 6.7 to 24.9 months. Twelve studies reported on RTW at any capacity, with rates ranging from 41% to 100%. Seven studies reported rates of RTW at preinjury capacity, ranging from 39.3% to 100%. For both RTS and RTW outcomes, high heterogeneities precluded pooled estimates. Time taken to RTW ranged from 2.4 to 24.8 months. Substantially lower RTW rates were associated with multi-trauma dislocations and sedentary occupations.
Rates of RTS at any level and preinjury level ranged from 41.2% to 100% and 5.9% to 100%, respectively, with corresponding heterogeneity values of 91% and 83%. These rates have higher ceilings than reported in a previous systematic review. Currently, there is insufficient evidence to recommend one surgical approach over another.
Level IV, systematic review of Level III and IV studies. |
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| AbstractList | To provide an updated overview of return to sport (RTS) and return to work (RTW) after surgical management of multiligament knee injuries (MLKIs).
A search was conducted across the MEDLINE, Embase, and PubMed databases from inception to August 26, 2024. Studies published after 2018 that reported on rates of RTS or RTW after multiligament knee reconstruction were included. Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines were followed, and a quality assessment was performed using the Methodological Index for Non-randomized Studies (MINORS) criteria. Data on study characteristics, demographic characteristics, and surgical details were extracted. Rates of RTS or RTW at the same level or at any level of participation were recorded. Random-effects models were used to generate forest plots.
Fifteen studies reported on RTS, with rates ranging from 41.2% to 100% when investigating RTS at any level. Thirteen studies reported rates of return to preinjury level, ranging from 5.9% to 100%. RTS rates at any level and preinjury level had higher ceilings than shown in a prior systematic review. Time taken to RTS ranged from 6.7 to 24.9 months. Twelve studies reported on RTW at any capacity, with rates ranging from 41% to 100%. Seven studies reported rates of RTW at preinjury capacity, ranging from 39.3% to 100%. For both RTS and RTW outcomes, high heterogeneities precluded pooled estimates. Time taken to RTW ranged from 2.4 to 24.8 months. Substantially lower RTW rates were associated with multi-trauma dislocations and sedentary occupations.
Rates of RTS at any level and preinjury level ranged from 41.2% to 100% and 5.9% to 100%, respectively, with corresponding heterogeneity values of 91% and 83%. These rates have higher ceilings than reported in a previous systematic review. Currently, there is insufficient evidence to recommend one surgical approach over another.
Level IV, systematic review of Level III and IV studies. |
| Author | Tapasvi, Sachin Dworsky-Fried, Joshua Kotipalli, Satyavenkata Alomari, Meshal Martin, Ryan Vivekanantha, Prushoth Moatshe, Gilbert de Sa, Darren |
| Author_xml | – sequence: 1 givenname: Joshua surname: Dworsky-Fried fullname: Dworsky-Fried, Joshua email: josh.dworsky-fried@medportal.ca organization: Michael DeGroote School of Medicine, McMaster University, Hamilton, Canada. Electronic address: josh.dworsky-fried@medportal.ca – sequence: 2 givenname: Satyavenkata surname: Kotipalli fullname: Kotipalli, Satyavenkata organization: Michael DeGroote School of Medicine, McMaster University, Hamilton, Canada – sequence: 3 givenname: Prushoth surname: Vivekanantha fullname: Vivekanantha, Prushoth organization: Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, Canada – sequence: 4 givenname: Meshal surname: Alomari fullname: Alomari, Meshal organization: Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, Canada – sequence: 5 givenname: Sachin surname: Tapasvi fullname: Tapasvi, Sachin organization: Orthopaedics, Sahyadri Super Specialty Hospital, Deccan Gymkhana, Pune, India – sequence: 6 givenname: Gilbert surname: Moatshe fullname: Moatshe, Gilbert organization: Oslo Sport Trauma Research Center, Norwegian School of Sports Science, Oslo, Norway; Department of Arthroscopy and Sports Medicine, Oslo University Hospital Aker, University of Oslo, Oslo, Norway – sequence: 7 givenname: Ryan surname: Martin fullname: Martin, Ryan organization: McCaig Institute for Bone and Joint Health, University of Calgary, Calgary, Canada; Department of Surgery, University of Calgary, Calgary, Canada – sequence: 8 givenname: Darren surname: de Sa fullname: de Sa, Darren organization: Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, Canada |
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| Snippet | To provide an updated overview of return to sport (RTS) and return to work (RTW) after surgical management of multiligament knee injuries (MLKIs).
A search was... |
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| SubjectTerms | Athletic Injuries - surgery Humans Knee Injuries - surgery Ligaments, Articular - injuries Ligaments, Articular - surgery Return to Sport - statistics & numerical data Return to Work - statistics & numerical data |
| Title | Rates of Return to Sport After Surgical Management of Multiligament Knee Injuries Are Higher Than Previously Described yet Highly Heterogeneous: A Systematic Review |
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