When Is It Safe to Return to Sport After ACL Reconstruction? Reviewing the Criteria

CONTEXT: There is an ever-increasing trend toward sports, fitness, and recreation activities, so the incidence of anterior cruciate ligament sports injuries has increased. Perhaps the greatest challenge for sports clinicians is to return the injured athlete back to his/her original sport at an even greater level of functional ability than preinjury. For this, rigorous and well-researched criteria are needed. EVIDENCE ACQUISITION: . STUDY DESIGN: Descriptive review. LEVEL OF EVIDENCE: Level 2. RESULTS: Five principal criteria were found, including psychological factors, performance/functional tests, strength tests, time, and modifiable and nonmodifiable risk factors. CONCLUSION: The psychological readiness of the player is a major factor in successful safe return to sport (SRTS) decision making. Although strength, performance, and functional tests presently form the mainstay of SRTS criteria, there exists very little scientific evidence for their validity. More protection should be provided to athletes with known risk factors. Movement quality is important, if not more important than the quantifiable measures. As a result of the significantly high rerupture rate in young individuals, delayed SRTS should be considered preferably beyond 9 months postsurgery.