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I'm disappointed that I didn't do better after my ACL repair two years ago. I thought I would be able to get back to my favorite sports (soccer and basketball) at the same level if not better than before the surgery. I'm not really playing either sport anymore. Does this happen to everyone?

Reports vary on return to sports activity levels based on many different factors. Age, gender, and preinjury level of participation are just a few of these variables. Type of injury (ACL alone, ACL plus meniscus tear, ACL plus meniscus and/or cartilage tear) can make a difference.

And results may vary depending on the type of repair done (allograft versus autograft). An allograft uses tendon tissue from a donor bank. Autograft means the surgeon harvests tissue from the patient to use as a graft.

Many studies report normal or nearly normal results for about 70 to 75 per cent of the patients in both groups. This does mean that about 25 per cent report less than normal results with reduced activity levels.

A recent study comparing just allograft repairs showed a general decline in sports activity for all patients from two to five years. A decline was seen from two to four years with an even greater report of decline in function after five years. The authors suspect patients may protect the joint at first, become deconditioned, and later experience the ongoing effects of decline with aging.

There is also the possibility of memory bias. This refers to the fact that some patients remember their physical condition and sports ability before treatment as being better than after treatment. Perceived skills and abilities and actual function may not be the same.

If your surgeon says your knee is stable, then a proper rehab training program may be all you need to get you back in the game. Make a follow-up appointment for testing. Share your personal sports activity goals with the doctor, and see if there's anything holding you back physically.

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