SOURCE: American Academy of Orthopaedic Surgeons
LAS VEGAS (March 12, 2019)—While there has been extensive research on when to return to sports, physicians do not have sufficient empirical evidence at their disposal to counsel adolescent and college-aged patients as to when they can return to school following surgery.
“Return to School Following Orthopaedic Sports Medicine Procedures: A Prospective Study of Adolescents and Young Adults” was presented today at the 2019 Annual Meeting of the American Academy of Orthopaedic Surgeons (AAOS). Zaira S. Chaudhry, MPH, a medical student, class of 2019, at Geisinger Commonwealth School of Medicine in Scranton, Pennsylvania, and a sports medicine research fellow at the Rothman Orthopaedic Institute in Philadelphia, determined the average time needed for adolescent and college students to return to school following surgery, and potential barriers preventing their return.
“’When can I return to school?’ is one of the most common questions patients and parents ask their orthopaedic surgeon,” said Chaudhry. “Up until now, surgeons have given patients a ballpark. Our goal was to take it from a question answered based on anecdotes to one based on evidence.”
The prospective, cohort study analyzed 101 patients (48.6 percent female, 51.5 percent male) between the ages of 14 and 25 (mean age of 18.7 years). Within this group:
- Students were enrolled in school on a full-time basis, with 8 percent of patients enrolled in middle or high school and 41.2 percent enrolled in college.
- Procedures performed among the patients were for common injuries sustained within this age group including:
- ACL reconstruction (54.5 percent)
- ACL reconstruction with meniscal repair (7.9 percent)
- Arthroscopic shoulder labral repair (19.8 percent)
- Arthroscopic hip labral repair (9.9 percent)
- Partial meniscectomy or meniscal repair (7.9 percent)
At two weeks postoperatively, patients were asked to complete a survey regarding time to return to school and barriers to returning to school. At six weeks and 12 weeks following surgery, patients were asked to complete another survey inquiring about difficulties faced upon returning to school and their academic performance.
The study found:
- The range for the number of days, including weekends, to return to school after surgery are:
- 1-14 days for ACL reconstruction
- 4-12 days for ACL reconstruction with meniscal repair
- 1-9 days for arthroscopic shoulder labral repair
- 3-16 days for arthroscopic hip labral repair
- 2-7 days for partial meniscectomy or meniscal repair
- Although the actual school environment and handicap accessibility was not evaluated in this study and may be a factor in some locations, the top three cited barriers for failing to return to school sooner were not feeling ready to return, pain and restricted mobility.
- At six weeks postoperatively, 13.3 percent of patients felt the timing of their surgery negatively impacted their school performance.
- 7.1% reported failing an exam within the six months before the surgery.
- Twice that number (14.3%) reported failing an exam after their surgery.
There are over 2.5 million emergency visits each year for sports-related injuries among individuals between the ages of 5 and 24 years, and orthopaedic injuries including sports-related injuries, are relatively common among adolescents and college-aged individuals.
Although this is a relatively small study, “given the prevalence of sports-related injuries in this group of patients, it is our hope that surgeons can utilize this information to counsel their patients and their parents to help them better plan for their recovery,” added senior author, Sommer Hammoud, MD, orthopaedic surgeon specializing in sports medicine at Rothman Orthopaedic Institute. Parents should also pay more attention to making school work up after an injury since exam failure rates also increase after a sports injury requiring surgery, although this increase was not statistically significant.
2019 AAOS Annual Meeting Disclosure Statement
With more than 39,000 members, the American Academy of Orthopaedic Surgeons is the world’s largest medical association of musculoskeletal specialists. The AAOS is the trusted leader in advancing musculoskeletal health. It provides the highest quality, most comprehensive education to help orthopaedic surgeons and allied health professionals at every career level best treat patients in their daily practices. The AAOS is the source for information on bone and joint conditions, treatments and related musculoskeletal health care issues and it leads the health care discussion on advancing quality.
