Article Abstract

Current criteria for return to play after anterior cruciate ligament reconstruction: an evidence-based literature review

Authors: Kala Y. Flagg, Spiridon G. Karavatas, Sam Thompson Jr, Craig Bennett


Anterior cruciate ligament reconstruction (ACLR) has continued to be a popular surgical option in the last decade, and frequently we have seen athletes complete successful surgical intervention and rehabilitation. Even more so, the time that it takes some athletes to return to play (RTP) has gained a lot of media attention. In light of these conditions, we set out to examine the status of research on rehabilitation protocols, tests and measures, and criteria for RTP after ACLR, especially bone-tendon-bone (BTB) procedures. An evidence-based literature review was conducted. PubMed and CINAHL database searches were performed using various combinations of the following keywords: ACL reconstruction, bone to bone graft, rehabilitation. The search was limited to systematic reviews of randomized control trials (RCT) published within the last 10 years in the English language. Ten systematic reviews were identified and nine of them were included in this review. Conflicting and inconsistent evidence exists for determining RTP criteria for athletes following ACLR. None of the systemic reviews established strong evidence for the specific qualities a patient should possess prior to returning to sport in order to minimize reinjury of the same knee or sustaining a new injury to the contralateral limb. There appears to be little consensus on what exactly should constitute RTP testing criteria following an ACLR. In addition, variance exists within the exact rehabilitation timeline and goals used to determine how ACLR rehabilitation protocols are structured. What is currently agreed upon for individuals participating in sports involving side to side/pivoting movements, ACLR is the preferred surgical procedure for returning these individuals back to their respective field of play after an ACL injury.