Knee Flexion Symmetry Is Related To Return-To-Sport Criteria After Anterior Cruciate Ligament Reconstruction
Lesser, Eliana
Lesser, Eliana
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Abstract
Knee Flexion Symmetry is Related to Return-To-Sport Criteria After Anterior Cruciate Ligament Reconstruction Background: Nearly 1 in 4 young athletes who return to high-risk sports following an ACL injury will sustain a secondary ACL injury during their athletic careers.1 To reduce secondary injury risk after ACL reconstruction (ACLR), minimum symmetry scores of 90% of the uninvolved limb for quadriceps strength and the triple hop test are recommended to begin a return-to-sport progression.2 Despite these recommendations, many do not meet these criteria before returning to sport.2 It remains unclear whether meeting current symmetry recommendations is sufficient to ensure normal knee function and reduce secondary injury risk. The goal of this study is to determine how many participants met return-to-sport symmetry criteria following ACLR, and the relationship between meeting these recommendations and knee biomechanical symmetry during the triple hop test. Methods: 58 young active individuals who underwent ACLR surgery and were cleared for return-to-sport performed a triple hop test. Reflective markers were placed on the hip, knee, and ankle. Joint angles were calculated from the second hop landing, and quadriceps strength was measured. Participants were grouped by whether they did or did not meet return-to-sport criteria for analysis. Results: 41% of participants cleared for return-to-sport met the recommended strength and hop distance symmetry criteria. Those who met the criteria had more symmetrical knee biomechanics at peak knee flexion (97 � 11.5) than the group that did not meet the cutoff criteria (91.5 � 7.8) (p = 0.043). The ACLR knee was less flexed in both groups. Discussion: Meeting recommended cutoffs resulted in more knee symmetry, however, asymmetries in knee biomechanics persisted in both groups. Current return-to-sport cutoff criteria may not be stringent enough to ensure symmetry. More patients meeting criteria before beginning a return-to-sport progression may reduce secondary ACL injury incidence. References 1Wiggins AJ, Grandhi RK, Schneider DK, Stanfield D, Webster KE, Myer GD. Risk of Secondary Injury in Younger Athletes After Anterior Cruciate Ligament Reconstruction: A Systematic Review and Meta-analysis. Am J Sports Med. 2016;44(7):1861-1876. doi:10.1177/0363546515621554 2Toole AR, Ithurburn MP, Rauh MJ, Hewett TE, Paterno MV, Schmitt LC. Young Athletes Cleared for Sports Participation After Anterior Cruciate Ligament Reconstruction: How Many Actually Meet Recommended Return-to-Sport Criterion Cutoffs? J Orthop Sports Phys Ther. 2017;47(11):825-833. doi:10.2519/jospt.2017.7227
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Date
1/1/2026
Student Status
Sophomore (Graduating in 2028)
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Poster
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Public Health Sciences
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College of Nursing and Health Sciences
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Clinical Science