Better safe than sorry? A systematic review with meta-analysis on time to return to sport after ACL reconstruction as a risk factor for second ACL injury

Key Points

1. Patients that had a second anterior cruciate ligament (ACL) injury returned to sport 25 days sooner than those who did not sustain a second ACL injury.

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BACKGROUND & OBJECTIVE

Despite advances in surgical and rehabilitation approaches, the re-injury rate following anterior cruciate ligament reconstruction (ACLR) is reported to be approximately 20%, and is even higher in young, active individuals returning to cutting or pivoting sports (1). While the timing of return to sport (RTS) has been hypothesized as a potential risk factor for re-injury, no systematic review has specifically addressed this question.

Therefore, this systematic review was conducted to compare the time to RTS between patients who experienced a second ACL injury and those who did not following primary ACLR.

The re-injury rate following anterior cruciate ligament reconstruction is reported to be approximately 20%.

Clinicians should collaborate with patients on return to sport decisions, using both functional and time criteria.

METHODS

• This review included any clinical studies that reported on time to RTS after ACLR and a second ACL injury. No standardized definition of RTS was applied. RTS was defined as days from primary ACLR to meeting RTS definition within the

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