Objective Criteria for Return to Athletics After Anterior Cruciate Ligament Reconstruction and Subsequent Reinjury Rates: A Systematic Review

Abstract

Few objective functional criteria are used to determine when patients return to unrestricted sports activities. Clinically feasible recommendations are made for measurement of muscle strength, lower limb symmetry, lower limb neuromuscular control, and ligament function in patients who desire to return to athletics after ACL reconstruction. Future studies are required to determine whether the demonstration of normal lower limb function before return to sports is effective in reducing reinjury rates.

Return to sport: Does excellent 6-month strength and function following ACL reconstruction predict midterm outcomes?

“…Unfortunately, these studies do not provide enough evidence to discern a relationship between the RTS criteria and subsequent ACL injury. Surgical technique, graft selection, and rehabilitation protocol, as well as follow-up duration, were all variable [9].…”

Analysis of lower limb force in foot work exercise of Pilates

“…In addition, the return to symmetry of limbs is a common goal in rehabilitation processes (32) and symmetry in force production is often emphasized in strength training programs (27). Thus, the importance of assessing unilateral force for the diagnosis of possible imbalances, prescription and monitoring of rehabilitation and training programs is highlighted.…”

Additional perspectives on ‘ACL rupture is a single leg injury but a double leg problem…’

“…2 Often, strength and hop tests are used, calculating an LSI (the ratio of injured/non-injured sides), and LSI >90% is frequently suggested as a cut-off criteria. 3 However, individuals with ACL reconstruction rarely reach 90% symmetry. 4 Moreover, impaired capacity on both sides after ACL injury is well known, underestimating deficits measured as LSI.…”