Return to Sport After Anterior Cruciate Ligament Injury: Panther Symposium ACL Injury Return to Sport Consensus Group

Abstract

Background: A precise and consistent definition of return to sport (RTS) after anterior cruciate ligament (ACL) injury is lacking, and there is controversy surrounding the process of returning patients to sport and their previous activity level. Purpose: The aim of the Panther Symposium ACL Injury Return to Sport Consensus Group was to provide a clear definition of RTS after ACL injury and a description of the RTS continuum as well as provide clinical guidance on RTS testing and decision-making. Study Design: Consensus statement. Methods: An international, multidisciplinary group of ACL experts convened as part of a consensus meeting. Consensus statements were developed using a modified Delphi method. Literature review was performed to report the supporting evidence. Results: Key points include that RTS is characterized by achievement of the preinjury level of sport and involves a criteria-based progression from return to participation to RTS and, ultimately, return to performance. Purely time-based RTS decision-making should be abandoned. Progression occurs along an RTS continuum, with decision-making by a multidisciplinary group that incorporates objective physical examination data and validated and peer-reviewed RTS tests, which should involve functional assessment as well as psychological readiness. Consideration should be given to biological healing, contextual factors, and concomitant injuries. Conclusion: The resultant consensus statements and scientific rationale aim to inform the reader of the complex process of RTS after ACL injury that occurs along a dynamic continuum. Research is needed to determine the ideal RTS test battery, the best implementation of psychological readiness testing, and methods for the biological assessment of healing and recovery.

The Muscle Strength of the Knee Joint after ACL Reconstruction Depends on the Number and Frequency of Supervised Physiotherapy Visits

“…The patients who want to return to training and next to return to dynamic sport the supervised physiotherapy (SP) should continue for at least six or more months [13,14]. The final decision to return the patient to sports activity should be based on a clinical examination, an assessment of the restored functions of the joint and the whole body, and the patient's mental readiness [15]. Czuppon et al (2014) suggested that variables associated with a return to sports after ACLR included higher quadriceps strength, less effusion, less pain, greater tibial rotation, higher activity score, higher athletic confidence, higher preoperative knee selfefficacy, lower kinesiophobia, and higher preoperative self-motivation [16].…”

Disrupted knee – disrupted me: a strenuous process of regaining balance in the aftermath of an anterior cruciate ligament injury

“…These negative feelings and psychological aspects may play an important role for recovery and psychological factors may predict outcomes after an ACL-R [ 33 ]. Even though a recent consensus statement article concludes that psychological factors play an important role in return to sport, it remains unclear if psychological scales can be used to capture this and improve the rehabilitation process [ 34 ]. Thereto, a study by Piussi et al 2021 suggested that physiotherapists express insufficient knowledge of how to address psychological impairments during rehabilitation [ 35 ].…”

National Football League Wide Receivers and Running Backs Have Decreased Production Following ACL Reconstruction: An Evaluation of Fantasy Football Performance as an Outcome Measure

“…7 Between 21% and 37% of NFL athletes who suffer an ACL injury never appear in another NFL game. 2,16 Those who do RTP have been shown to perform at a lower level on average than they did before injury. 2 The physical demands imposed on NFL athletes predispose them to greater injury risk in comparison to the general population.…”