Are athletes ready to return to competitive sports following ACL reconstruction and medical clearance?

Return to sports after anterior cruciate ligament reconstruction (ACLR) is often based on medical clearance and the rehabilitation teams’ decision regarding the physical readiness of athletes. However, re-injury and contralateral injuries are increasing. The purpose of the study was to assess the readiness for return to sport in a sample of division III athletes following ACL reconstruction. Twenty-one collegiate athletes (7 males and 14 females) with ACLR and medical clearance to return to sport were recruited. The functional performance of the athletes and the symmetry of both lower extremity measures were evaluated using motion/force-plate analysis, balance, core strength/endurance and functional knee performance testing. Athlete performance reports were provided with training suggestions. The operated lower extremities had a significant decrease in vertical ground reaction force, less knee flexion and more valgus during a single-leg landing task, lower balance scores and reduced hop distance for the majority of participants. Participants continued to show a reduction in operated legs’ performance despite being medically cleared for sports. Lasting deficiencies and their magnitude may explain the increased tendencies for re-injury following ACLR as reported in the literature. Safe return to sport following ACLR should be based on achieving symmetry of performance of lower extremities. A thorough assessment of an athlete’s performance using a comprehensive examination can identify deficiencies and can be used to guide clinical decision-making.

前交叉韧带重建（anterior cruciate ligament reconstruction, ACLR）术后重返运动，通常取决于医疗许可与康复团队对运动员身体就绪状态的评估。然而，术后再损伤与对侧肢体损伤的发生率正呈上升趋势。本研究旨在评估III级联赛大学生运动员经前交叉韧带重建术后的重返运动就绪状态。研究共招募21名已完成前交叉韧带重建且获得医疗许可重返运动的大学生运动员，其中男性7名、女性14名。采用运动/测力台分析、平衡能力测试、核心力量/耐力测试及膝关节功能表现测试，对运动员的功能表现与双下肢指标对称性进行评估，并为每名运动员提供个人表现报告及针对性训练建议。结果显示，多数受试者的患侧下肢在单腿落地任务中表现为垂直地面反作用力显著降低、膝关节屈曲角度减小、外翻角度增大，平衡评分更低且跳跃距离更短。尽管已获得运动重返的医疗许可，受试者的患侧下肢功能仍存在显著不足。这类持续存在的功能缺陷及其严重程度，或可解释文献中报道的前交叉韧带重建术后再损伤风险升高的现象。前交叉韧带重建术后的安全重返运动，应建立在双下肢功能表现达到对称水平的基础上。通过全面检查对运动员的功能状态进行细致评估，可有效识别其功能缺陷，进而指导临床决策制定。