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Return to sports after anterior cruciate ligament injury: neither surgery nor rehabilitation alone guarantees success—it is much more complicated
  1. R Thomeé1,
  2. M Waldén2,
  3. M Hägglund3
  1. 1Department of Health and Rehabilitation, Unit of Physiotherapy, Gothenburg University, Institute of Neuroscience and Physiology, Göteborg, Sweden
  2. 2Department of Medical and Health Sciences, Division of Community Medicine, Linköping University, Linköping, Sweden
  3. 3Department of Medical and Health Sciences, Division of Physiotherapy, Linköping University, Linköping, Sweden
  1. Correspondence to R Thomeé, Department of Health and Rehabilitation, Unit of Physiotherapy, Gothenburg University, Institute of Neuroscience and Physiology, 40530 Göteborg, Sweden; roland.thomee@orthop.gu.se

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Complex factors influence the likelihood of anterior cruciate ligament (ACL)-injured athletes to return to sports. For example, a systematic review from 20141 found weak evidence that higher quadriceps strength, less effusion, less pain, greater tibial rotation, higher Marx Activity score, higher athletic confidence, higher preoperative knee self-efficacy, lower kinesiophobia and higher preoperative self-motivation were associated with returning to sport after ACL reconstruction. Another recent systematic review2 found that hopping performance, younger age, male gender, participation in elite sport and having a positive psychological response favoured returning to the preinjury level of sport. Similarly, a systematic review3 of level II and III studies found that the following factors contributed to better functional outcomes after ACL reconstruction: male gender, age less than 30 years, reconstruction within 3 months and high baseline activity level. Outcome after rehabilitation was negatively affected …

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