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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 …
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.