Project 440075

The anterior cruciate ligament (ACL) is the most frequently damaged knee ligament, with rates continuing to rise among active paediatric athletes. Moreover, the risk of ACL re-injury after surgical reconstruction (ACLR) is significantly higher than the initial injury. Despite the high risk for re-injury, and the lifelong associated health implications, there is minimal evidence available to guide return-to-activity (RTA) timing following a paediatric ACLR. One of the barriers restricting the development of RTA criteria are limitations on what can be collected in a clinical setting, as many factors associated with ACL re-injury risk require access to specialized laboratories. To address this issue, my thesis will achieve the following objectives: i) validate a novel suite of mobile technologies, ii) use the technology and a multidisciplinary approach to develop a decision rule for RTA timing, and iii) implement the decision rule into clinical practice. Through an established collaboration with orthopaedic surgeons at the Children's Hospital of Eastern Ontario (CHEO), we will recruit paediatric patients who have undergone an ACLR. Data will be collected following the patient's ACLR during a series of dynamic tasks (ex. side-cuts) using clinically accessible mobile technologies. We will use this data to identify variables that predict positive clinical outcomes (ex. re-injury). Based on these measurements, cut-off thresholds can be identified to determine whether a paediatric patient is ready to RTA. The final phase of the project will focus on implementing the decision rule into clinical practice at CHEO. This project will create the first clinically accessible paediatric-specific RTA decision rule, reducing the risk for premature RTA and subsequent ACL re-injury. Furthermore, by ensuring our suite of technologies is transferable to other institutions, this project has the potential to improve the quality of care for all young Canadians recovering from an ACLR.