Criteria for Return to Play After Anterior Cruciate Ligament Reconstruction

Abstract

Anterior cruciate ligament reconstruction (ACLR) is a common orthopaedic procedure often sustained during sports-related trauma. Many patients desire to return to play (RTP) following surgery, and modern advances in rehabilitation and surgical techniques aim to facilitate this. Preoperative rehabilitation and postoperative accelerated rehabilitations programs have both demonstrated positive outcomes in facilitating RTP following ACLR. Many preoperative, intraoperative, and postoperative factors influence time to RTP and rate of re-injury, including patient demongraphics, graft choice, and postoperative rehabilitation program. To maximize safe RTP, these factors need to be considered. Work is underway to develop objective guidelines for the time to RTP, and current research suggests that a combination of kinematic, neuromuscular, and psychological factors need to be considered.

Introduction

Modern surgical techniques and rehabilitation protocols have led to improved surgical outcomes following anterior cruciate ligament (ACL) injury and have made return to play (RTP) a realistic goal for athletes. The incidence of anterior cruciate ligament reconstruction (ACLR) surgery has been increasing in recent decades, and the desire to return to preinjury activity levels acts as a motivator for surgery in many patients. Ardern et al. reported that 81% of people return to any sport following ACLR, and 65% return to preinjury level of activity after surgery. After ACLR, it is certainly possible for athletes in a variety of sports to successfully RTP ( Table 119.1 ). However, significant controversy remains regarding RTP criteria, which is influenced by preoperative, intraoperative, and postoperative factors.

TABLE 119.1

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