New Delhi [India], September 13 (ANI/PNN): The highly charged, defining question that almost every athlete asks their doctor after suffering anterior cruciate ligament (ACL) damage is, "When can I play again, Doc?" Parents, teammates, coaches, and--in the case of the well-known athlete--the media always start by asking the same question. It implies that quick surgical intervention and expedited recuperation become priorities to match the expectations of athletes or their surroundings. Therefore, it is not strange if the benchmark by which orthopedic doctors judge themselves and are judged in sports circles is the time to return to play.

By these criteria, ACL therapy programs in sports medicine have come a long way over the preceding two decades. The lengthy casts to arthroscopic surgery, ranging from excess hospital stays to outpatient surgery, from protracted castings to short-term bracing, and from slow to quick rehabilitation programs.

Today, it is assumed that an arthroscopic procedure should performed a few weeks after an athlete sustains an injury, that rehabilitation will begin right away, and that the patient will be able to return to sports in four to nine months. The "greatest" surgeons and physical therapists supposedly allow players to return even earlier.

Are there any other metrics we should use to gauge the success of our treatments besides when we may resume our athletic activities?

It is understandable that we hardly ever question ourselves, "Is it time to quit?" since we are so consumed with the desire to achieve and the fear of failure permeates every aspect of our decision-making. Is it okay for patients to resume pivoting sports? What are the treatment programs' long-term effects?

Is there another metric by which we should evaluate the success of the treatment outside the time it takes to resume sports? Should we not advise the athlete after the initial injury taking into account the dangers of a graft rupture or other knee lesions and the probability of developing early osteoarthritis (OA)?

Analytical Proofs For ACL Injuries

The researched literature for follow-up studies after ACL injuries looks at the rate of return to sport, the risk of re-injury, and/or the prevalence of OA to better address these issues.

Return to Sports Post ACL Injuries

- The usual recommendation for athletes who want to return to pivoting sports is an ACL restoration after 4-8 weeks. After 4 to 8 weeks, when the full range of motion has established, there is no joint swelling, the standard recommendation is an ACL reconstruction.

- By limiting anteroposterior joint motion, an ACL reconstruction lowers the risk of further injury to the menisci and cartilage while providing the athlete with a mechanically stable knee.

- Several short-term trials have demonstrated well to outstanding knee function following reconstruction, regardless of the use of hamstring or patellar tendon grafts.

- The majority of patients (65-88 per cent) can resume sports within the first year, according to the same studies.

- Thus it is fair to state that surgery is beneficial in allowing wounded players to resume their sporting careers. Additionally, some athletes can resume playing pivoting sports at a high level without surgery. The return rate for patients receiving non-operative treatment ranges from 19 per cent to 82 per cent.

- The athletes who successfully resume competing following non-operative treatment probably represent a niche population with stable knees that function normally and a strong desire to keep competing in sports despite their injuries.

How long may sportsmen continue playing after their first injury, whether they need an ACL reconstruction or not?

The majority of research focuses on patients who have had their ACLs repaired, and the results range from 8 per cent to 82 per cent. The authors' reporting of either an initial return rate or the percentage of players who were still active at the time of follow-up, however, is not always apparent.

Nevertheless, a few studies may be of particular interest since they track patient populations with sports-specific injuries and provide information on both surgically treated and non-surgically treated individuals. Furthermore, elite athletes who are likely to be highly driven to continue their athletic careers are mostly included in these studies. As a result, the statistics may offer a reasonable estimation of what to anticipate upon a return to sport after an injury.

Dr Reetadyuti Mukhopadhyay is a dedicated sports and arthroscopic surgeon proficient in Bankart, SLAP, RC repair, Total Reverse Shoulder Arthrosplasty, meniscus surgery, etc. He has a specific interest in arthroscopic shoulder procedures. He is also an expert in ACL and knee ligament surgery as well as sophisticated shoulder reconstruction procedures. He is currently working with the top hospital in Gurugram.

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