The majority of athletes fail to return to play following anterior cruciate ligament reconstruction due to reasons other than the operated knee

Review written by Dr Christina Le info

Key Points

  1. Individuals who undergo ACL reconstruction report reasons both related and unrelated to their knee injury for not returning to play.
All key points available for members only


Many people who have undergone anterior cruciate ligament reconstruction (ACLR) state that their main rehabilitation goal is to return to their sport. Unfortunately, we know from previous research that roughly 1-in-3 individuals do not return to sport at the same pre-injury level, and 1-in-4 individuals do not return to any sport (1). What is less clear though, is the reasons individuals have for not returning to play (RTP).

Persistent knee symptoms and fear of re-injury are 2 possible barriers to RTP, however, it is likely that other contextual factors may play an important role in the RTP decision. The objective of this study was to evaluate reasons why athletes did not RTP following ACLR.

Roughly 1-in-3 individuals do not return to sport at their pre-injury level after ACL reconstruction.
Fear of re-injury and lack of confidence are often cited as reasons for patients to avoid returning to play, more so than physical issues with the knee itself.


This study collected data from participants who underwent a primary ACLR with a hamstring or bone-patellar tendon-bone autograft between 2014-2016. All participants followed a standardized rehabilitation program with a local physiotherapist that included strength training, plyometrics, running, and return to

to unlock full access to this review and 989 more