Returning to Performance After ACL Injury in Competitive Alpine Skiing: A Scoping Review and Evidence- and...

Area of Science:

• Sports Medicine
• Orthopedics
• Rehabilitation Science

Background:

• Anterior cruciate ligament (ACL) injuries are prevalent in competitive alpine skiing.
• Return-to-performance (RTP) pathways after ACL injury present significant challenges for athletes.

Purpose of the Study:

• To conduct a scoping review of research on RTP after ACL injury in competitive alpine skiers.
• To identify key recovery factors, knowledge gaps, and synthesize evidence- and expert-informed practice recommendations for RTP.

Main Methods:

• A comprehensive literature search was performed across four electronic databases.
• 35 studies focusing on competitive alpine skiers with ACL injuries were included after screening.
• Data on injury, surgery, rehabilitation, testing, and outcomes were extracted and synthesized.

Main Results:

• Most research focuses on epidemiology, risks, and early rehabilitation, with limited data on later recovery phases.
• There is a paucity of evidence on psychological and social factors influencing RTP.
• Knowledge gaps exist in understanding the complete RTP process for competitive alpine skiers.

Conclusions:

• A sport-specific, criteria-based, multi-domain RTP framework with stepwise progression is proposed.
• Further research is needed to address identified knowledge gaps.
• A comprehensive RTP protocol is provided as a guideline for evidence- and expert-informed practice.