Anterior Cruciate Ligament Injury Follow-up

Updated: Feb 26, 2021
  • Author: Matthew Gammons, MD; Chief Editor: Sherwin SW Ho, MD  more...
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Once quadriceps strength reaches 65% of the opposite leg, sports-specific activities may be performed; this usually occurs within 5-8 weeks postsurgery. This may be tested using a Cybex machine. The athlete may return to activity when the quadriceps strength has reached 80%, which is usually after at least 3-4 months of sports-specific therapy.

According to a study by Grindem et al, returning to level I sports after ACL reconstruction leads to a more than 4-fold increase in reinjury rates over 2 years. The study also found that return to sport 9 months or later after surgery and more symmetrical quadriceps strength prior to return substantially reduce the reinjury rate. [28]

A study by Kyritsis et al found that athletes who did not meet the discharge criteria before returning to professional sport had a four times greater risk of sustaining an ACL graft rupture compared with those who met all six return to sport criteria. The study also found that hamstring to quadriceps strength ratio deficits were associated with an increased risk of an ACL graft rupture. [29]