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AOSSM 2022 Annual Meeting Recordings - no CME
Q & A: Return to Play
Q & A: Return to Play
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Video Transcription
Thank you, Robin. We have a few minutes for questions, and I've received two or three from the audience. The first question is directed at Stephen. Mechanistically, why do you think the extra assessments help? Extra interventions or awareness of deficits, learning things, and others? Yeah, absolutely. So when we're giving these assessments, we give the report of how they're doing to the patient. We give it, obviously, to the orthopedic surgeon. But it also goes to their kind of rehab specialist team, whether that be their athletic trainer or their physical therapist. And so if we're doing this assessment while they're under the care of these individuals, that physical therapist, this athletic trainer, is able to get a report saying what these individuals are weak, where their deficits persist, and then, yes, they can adapt for that in their training. And so when they see us for a second time, hopefully we have kind of overcome those deficits. Lately, a lot of discussion has been focused on fear of re-injury as a reason why athletes do not return to play. Some say it's maybe the major reason. How have you factored that into your study? Yeah, so we didn't have this at the beginning of our study, but we implemented a questionnaire. It's the ACL RSI, Return to Sport Index, which assesses the psychological readiness to return to sport. And it's just a series of 12 questions. It's a Likert scale, pretty easy for the patients to complete. But that also gives us a data point of that issue. So if, functionally, our patients are performing really well, they're hesitant to get back to sport, or they're not scoring well on this questionnaire, maybe that allows us an opportunity to intervene elsewhere than just their physical rehab. So here's a question for Sai. What are your recommendations regarding functional ACL bracing when returning to play following a reconstruction? How long should bracing be encouraged, if at all? And how does this vary depending on the specific sport? To be quite honest, I don't think I have enough experience with ACL post-operative treatment. But especially when we're talking about an athlete cohort, I think there's so many other variables. In my limited experience, it seems as though athletes want to hang on to the functional bracing a little bit longer. But personally, I just don't have the experience to answer that question. What about the chronicity of the tear prior to reconstruction as a variable, either directly or indirectly, affecting the quadriceps strength or lack thereof, having an influence on the efficacy or not of restricted blood flow? Yeah, so that's actually a really good point. I didn't think about that. But in this cohort, especially with this being, like you say, athletes, their surgery usually happens pretty quickly. But when we translate this to a general population, I think that's definitely a variable that we need to look into. So Michael, do players that remain local following their ACL reconstruction, in other words, supervision, rehabilitation-wise, versus players that have ACL reconstruction and go off at a distance, does that have an effect on return to play and things like that? I'm not sure if the mic is working. So yeah, Pier Paolo, the primary surgeon, sort of tries to assist the athletes stay around for at least four weeks in Rome so they can supervise the rehab because he really believes that the reason he's able to get them back sooner is because they're not shutting down their quads. As I showed in those video clips, the players are like the day after they're in PT, they're working a couple hours twice a day. And I think that's why this patient population is a little bit different in this sense because they have access to the resources and they're able to be supervised. So a lot of the secondary things, they don't shut down their quads, they just recover more quickly. All right, I think we'll end the first session. I'd like to congratulate the authors and the papers. And Sharon will introduce the second sessions. I want to thank all the authors for this session, again, for their wonderful papers. And I'm sure that they'll be around for any questions that we didn't get answered or asked in this session. In the interest of time, we'll move on to our next speakers.
Video Summary
This video features a Q&A session with several speakers discussing the benefits of extra assessments, interventions, and increased awareness of deficits in aiding rehabilitation for athletes with ACL injuries. The speakers highlight the importance of sharing assessment reports with the patient, orthopedic surgeons, and rehab specialists, such as athletic trainers and physical therapists, to address weaknesses and adapt training accordingly. They also address the fear of reinjury and how it can impact an athlete's readiness to return to play, utilizing a psychological questionnaire to assess their readiness. The discussion also touches upon the use of functional ACL bracing during rehabilitation and the effect of chronicity of the tear on the efficacy of restricted blood flow. The session concludes with remarks from the moderator, thanking the speakers and introducing the next session.
Asset Caption
Stephan Bodkin, PhD, ATC; Sai Devana, MD; Brandon Erickson, MD; Robert Westermann, MD; Michael Battaglia, MD; Robin Dunn, MD
Keywords
ACL injuries
rehabilitation
assessment reports
athlete readiness
functional ACL bracing
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