Determinants of Functional Outcomes Following Anterior Cruciate Ligament Reconstruction in Nigerian Athletes: A Prospective Cohort Study

Anterior cruciate ligament (ACL) reconstruction is the surgical treatment of choice for ACL-deficient knees in athletes seeking to return to high-demand sports activities. Despite increasing availability of arthroscopic surgery in select Nigerian centres, the determinants of functional outcomes following ACL reconstruction in the Nigerian athletic population remain inadequately studied. This prospective cohort study investigates the clinical, demographic, and surgical determinants of functional outcomes at six and twelve months post-ACL reconstruction among competitive athletes presenting at three orthopaedic centres in Lagos and Ogun States, South West Nigeria. Patients will be assessed pre-operatively and at follow-up using the International Knee Documentation Committee (IKDC) subjective form, the Lysholm Knee Scale, and the Tegner Activity Level Scale. Variables including graft type, timing of surgery, pre-operative quadriceps strength symmetry, compliance with post-operative physiotherapy, and time to return to sport will be documented. Multilevel regression will be used to identify independent predictors of functional outcome. The study hypothesises that pre-operative strength deficits greater than 20 percent and non-compliance with structured physiotherapy are the strongest predictors of inferior outcomes. Findings will be published in a peer-reviewed orthopaedic journal and presented to the sports medicine community to improve ACL rehabilitation protocols in Nigeria. Keywords: ACL reconstruction, functional outcomes, Nigerian athletes, Lysholm scale, knee surgery.