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Return to sport after anterior cruciate ligament injury: Panther Symposium ACL Injury Return to Sport Consensus Group

Journal article
Authors S. J. Meredith
T. Rauer
T. L. Chmielewski
C. Fink
T. Diermeier
B. B. Rothrauff
Eleonor Svantesson
Eric Hamrin Senorski
T. E. Hewett
S. L. Sherman
B. P. Lesniak
Published in Knee Surgery Sports Traumatology Arthroscopy
Pages 12
ISSN 0942-2056
Publication year 2020
Published at Institute of Neuroscience and Physiology, Department of Health and Rehabilitation
Institute of Clinical Sciences, Department of Orthopaedics
Pages 12
Language en
Keywords Return to sport, Anterior cruciate ligament, Consensus statement, Rehabilitation, reconstruction surgery, physical-therapy, decision-making, to-play, performance, criteria, level, risk, time, metaanalysis, Orthopedics, Sport Sciences, Surgery
Subject categories Orthopedics


Purpose A precise and consistent definition of return to sport (RTS) after anterior cruciate ligament (ACL) injury is lacking, and there is controversy surrounding the process of returning patients to sports and their previous activity level. The aim of the Panther Symposium ACL Injury RTS Consensus Group was to provide a clear definition of RTS and description of the RTS continuum, as well as to provide clinical guidance on RTS testing and decision-making. Methods An international, multidisciplinary group of ACL experts convened as part of a consensus meeting. Consensus statements were developed using a modified Delphi method. Literature review was performed to report the supporting evidence. Results Key points include that RTS is characterized by achievement of the pre-injury level of sport and involves a criteria-based progression from return to participation to return to sport, and ultimately return to performance. Purely time-based RTS decision-making should be abandoned. Progression occurs along a RTS continuum with decision-making by a multidisciplinary group that incorporates objective physical examination data and validated and peer-reviewed RTS tests, which should involve functional assessment as well as psychological readiness. Consideration should be given to biological healing, contextual factors and concomitant injuries. Conclusion The resultant consensus statements and scientific rationale aim to inform the reader of the complex process of RTS after ACL injury that occurs along a dynamic continuum. Research is needed to determine the ideal RTS test battery, the best implementation of psychological readiness testing and methods for the biologic assessment of healing and recovery.

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