Anterior Cruciate Ligament Reconstruction Return to Sport Testing Passing Rates for Healthy People: A Systematic...

Area of Science:

• Orthopedics
• Sports Medicine
• Rehabilitation Science

Background:

• Return to sport (RTS) after anterior cruciate ligament (ACL) reconstruction (ACLR) is a common goal for athletes.
• High reinjury rates (20-25%) are associated with returning to sport after ACLR.
• Current RTS criteria may not adequately prepare athletes, as even healthy individuals often fail these tests.

Purpose of the Study:

• To systematically review existing literature to determine if healthy individuals can pass standard ACLR RTS rehabilitation tests.
• To synthesize data on the performance of healthy controls in common RTS assessment protocols.

Main Methods:

• A systematic literature search was conducted in May 2023 across PubMed, EMBASE, and SPORTDiscus, adhering to PRISMA guidelines.
• Studies involving ACLR RTS rehabilitation tests (strength, hop, balance) on healthy individuals were included.
• Duplicate searches and quality assessments were performed on retrieved studies.

Main Results:

• 32 studies involving 1552 healthy controls were analyzed.
• Significant percentages of healthy participants failed various tests: hop tests (5.3-42.2%), Star Excursion Balance Test (15.2%), isometric knee flexion (37%), isometric knee extension (50%), and drop vertical jump (23.7-28.9%).
• Isokinetic and isometric strength tests revealed limb asymmetry (≥10%) in a notable proportion of healthy individuals.

Conclusions:

• A substantial number of healthy individuals do not meet the criteria for common RTS tests used after ACLR.
• Some healthy individuals exhibit inherent side-to-side variations exceeding 10% in strength and hop tests.
• RTS testing thresholds require reevaluation to be practical and effective in reducing reinjury rates.