ACL: Time-Based Return to Play. “Role of Patient Reporting in Return to Play”

For the football athlete, returning to preinjury levels of participation is the primary objective after knee surgery. Assessment of return to football participation is often difficult and can be influenced by multiple factors and discrepancies in measurement methods. Considerable variation in return to participation in football exists in the literature, and in many cases a substantial proportion of athletes are unable to return to their preinjury level of sports participation. In addition to the multitude of physical and psychological factors that influence an athlete’s return to sports participation, the lack of a universally accepted definition of return to play that is utilized by all, also influences the reporting of return to play rates. In this chapter, the role of patient reporting in return to play decisions is discussed through evaluation of multiple, commonly utilized patient-reported measures of return to sports. Comparisons of the utility of unidimensional self-report and comprehensive assessments that require multidimensional information reveal the two methods of assessment may not provide similar information on return to play status and should not be used interchangeably. Multidimensional assessments that utilize the type and frequency of sports activity and participation assess multiple parameters of sports participation and provide the clinician with more information regarding sports participation status. There is need for clarity and standardization in regard to what patients and clinicians are assessing when evaluating return to play as an outcome.