Return to sport after ACL reconstruction: What to know? How to do?

Abstract

An injury of the anterior cruciate ligament (ACL) has profound effects for an athlete given the time lost from sports, the inherent physical and psychological effects as well as the long-term sequelae related to further joint pathology. Most athletes who wish to continue sports after an ACL injury are advised to undergo ACL reconstruction. The decision when an athlete is cleared to return to sport is multifactorial, difficult and challenging. Despite the development of return to sport guidelines over recent years, there are still more questions than answers on the most optimal return to sport criteria after ACL reconstruction. The lack of a scientific consensus on the return to sport criteria used to release a patient to unrestricted sport activity after ACL reconstruction, together with the shortcomings of the current return to sport criteria may contribute to the failure to identify residual biological and functional deficits and a premature return to sport, which may lead to increased ACL re-injury risk. During this workshop, a critical appraisal of current return to sport criteria after ACL reconstruction is presented. At the same time, recommendations for optimizations are presented based on current trends in literature, including the implementation of a multifactorial decision-making process and secondary injury prevention training. Based on the extensive use of video material, the goal is to present a highly interactive workshop with direct clinical implications.