Summary
Successfully passing RTS dynamic strength and movement control tests after ACLR may ensure the absence of re-rupture in the medium term.
Abstract
Introduction
Anterior cruciate ligament (ACL) rupture is one of the most common knee injuries. Despite the effectiveness of reconstruction, re-rupture rates of up to 15% have been reported. Static and dynamic strength and movement control tests are commonly used to determine when returning to sports (RTS) is appropriate.
Objective
To determine whether successfully passing RTS tests reduces the re-rupture rate.
Methods
This retrospective cohort study analyzed patients who underwent ACL reconstruction (ACLR) between June 2018 and May 2023 and completed RTS tests after rehabilitation. Patients who also underwent extra-articular tenodesis, osteotomy, or had multiligament injuries were excluded. The RTS tests included Repeat Sprint Ability (RSA), Dynamic Valgus, Pro-Agility, Unilateral Countermovement Jump (CMJ), Isokinetic Testing, the Triple Hop Test, and the Functional Movement Screen (FMS). Statistical analyses were performed using STATA version 18.0.
Results
A total of 95 patients underwent RTS testing after ACLR, with a mean follow-up of 27.8 months. Of these, 71.6% were male, with a mean age of 25.15 ± 10.7 years. The overall re-rupture rate was 13.68% (13 patients). There were no significant differences in sex (p = 0.06) or age (p = 0.11) between patients who passed and those who did not pass the RTS tests. The only statistically significant difference between the groups was the mean risk score (passed: 11.5 ± 0.7 vs. not passed: 15.5 ± 2.1; p < 0.001). Patients who experienced re-rupture were more likely to belong to the non-passed group (passed: 0% vs. not passed: 18.1%; p = 0.03), with a statistical power of 0.70.
Conclusion
Our findings suggest that successfully passing RTS tests after ACLR may ensure the absence of re-rupture in the medium term.