Functional performance tests as indicators of returning to sports after anterior cruciate ligament reconstruction

Knee. 2014 Jan;21(1):95-101. doi: 10.1016/j.knee.2013.08.017. Epub 2013 Sep 17.


Background: There is a lack of standardized objective criteria to accurately assess the ability of a patient to progress through the end stages of rehabilitation and safely return to their previous level of athletic activity after anterior cruciate ligament (ACL) reconstruction.

Purpose: To determine objective factors involved in returning to sports following ACL reconstruction.

Methods: Based on our inclusion criteria of a minimum 2-year follow-up, pre-injury sports activity level of Tegner 5 or greater, we retrospectively evaluated 67 patients who underwent ACL reconstruction. The patients were divided into "return-to-sports" (n=51) and "non-return" groups (n=16) by surveying participants using a questionnaire. Comparisons between the two groups were made using pre-operative and post-operative International Knee Documentation Committee questionnaires (IKDC), Lysholm score, and KT-2000 arthrometer. Flexor and extensor muscle strength, and functional performance tests (one-leg-hop test, co-contraction, shuttle run, and carioca tests) were used for assessment.

Results: Overall clinical results, including IKDC score, Lysholm score, and KT-2000 arthrometer, improved in all patients post-operatively and no significant difference was seen between the two groups (P>0.05). Although there was no significant difference in flexor or extensor deficits, one-leg-hop test, or shuttle run test, "return-to-sports" group obtained significantly better scores in the co-contraction and carioca tests (P<0.05).

Conclusions: Tests that assess rotational stability showed statistically significant differences between the two groups. Further prospective studies with larger cohort are needed to determine the factors associated with returning to sports after ACL reconstruction.

Level of evidence: Retrospective comparative study, Level III.

Keywords: Anterior cruciate ligament; Functional performance tests; Reconstruction; Return to sports.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anterior Cruciate Ligament Reconstruction* / methods
  • Anterior Cruciate Ligament Reconstruction* / rehabilitation
  • Arthrometry, Articular
  • Athletic Injuries / surgery
  • Exercise Test
  • Follow-Up Studies
  • Humans
  • Male
  • Muscle Strength
  • Patient Outcome Assessment*
  • Recovery of Function*
  • Retrospective Studies
  • Sports*
  • Surveys and Questionnaires
  • Young Adult