Return to Sport After Primary ACL Reconstruction in Amateur, Children, and Elite Athletes: Feasibility and Reinjury Concerns

Abstract

This chapter summarizes return to sport (RTS) and reinjury data after anterior cruciate ligament (ACL) reconstruction in 42, 275 patients from 95 studies published from 2004 to 2018. Three major categories of subjects are presented: amateur athletes of all ages (40 studies, 29, 711 athletes), children and adolescent athletes (31 studies, 10, 661 athletes), and elite collegiate and professional athletes (23 studies, 1903 athletes). In addition, factors associated with RTS and reinjuries (to either knee) from both univariate and multivariate analyses when conducted by the investigations are described. Criteria for release to unrestricted sports activities are detailed and an update provided from our previously published systematic review. Recommendations are provided for each category of athlete, taking into consideration the potential deleterious effects of premature RTS and reinjuries, as well as need for future ACL revision reconstruction.