title: Muscle strength and hop performance criteria prior to return to sports after ACL reconstruction.
abstract: OBJECTIVE
  The purpose of this article is to present recommendations for new muscle strength and hop performance criteria prior to a return to sports after anterior cruciate ligament (ACL) reconstruction.
  
  
  METHODS
  A search was made of relevant literature relating to muscle function, self-reported questionnaires on symptoms, function and knee-related quality of life, as well as the rate of re-injury, the rate of return to sports and the development of osteoarthritis after ACL reconstruction. The literature was reviewed and discussed by the European Board of Sports Rehabilitation in order to reach consensus on criteria for muscle strength and hop performance prior to a return to sports.
  
  
  RESULTS
  The majority of athletes that sustain an (ACL) injury do not successfully return to their pre-injury sport, even though most athletes achieve what is considered to be acceptable muscle function. On self-reported questionnaires, the athletes report high ratings for fear of re-injury, low ratings for their knee function during sports and low ratings for their knee-related quality of life.
  
  
  CONCLUSIONS
  The conclusion is that the muscle function tests that are commonly used are not demanding enough or not sensitive enough to identify differences between injured and non-injured sides. Recommendations for new criteria are given for the sports medicine community to consider, before allowing an athlete to return to sports after an ACL reconstruction.
authors.affiliation: Department of Orthopaedics, Lundberg Laboratory for Orthopaedic Research, Sahlgrenska University Hospital, 413 45 Göteborg, Sweden. roland.thomee@orthop.gu.se
authors.forename: Roland
authors.initials: R
authors.lastname: Thomeé
authors.forename: Yonatan
authors.initials: Y
authors.lastname: Kaplan
authors.forename: Joanna
authors.initials: J
authors.lastname: Kvist
authors.forename: Grethe
authors.initials: G
authors.lastname: Myklebust
authors.forename: May Arna
authors.initials: MA
authors.lastname: Risberg
authors.forename: Daniel
authors.initials: D
authors.lastname: Theisen
authors.forename: Elias
authors.initials: E
authors.lastname: Tsepis
authors.forename: Suzanne
authors.initials: S
authors.lastname: Werner
authors.forename: Barbara
authors.initials: B
authors.lastname: Wondrasch
authors.forename: Erik
authors.initials: E
authors.lastname: Witvrouw
mesh_terms: D016118:Anterior Cruciate Ligament / Q000601:surgery*; D000070598:Anterior Cruciate Ligament Injuries; D001265:Athletic Injuries / Q000503:physiopathology / Q000601:surgery*; D003657:Decision Making; D003661:Decision Support Techniques; D004185:Disability Evaluation; D006801:Humans; D007718:Knee Injuries / Q000503:physiopathology / Q000601:surgery*; D053580:Muscle Strength / Q000502:physiology*; D010003:Osteoarthritis / Q000209:etiology*; D011788:Quality of Life; D016059:Range of Motion, Articular / Q000502:physiology*; D019651:Plastic Surgery Procedures; D020127:Recovery of Function / Q000502:physiology*; D012008:Recurrence; D018570:Risk Assessment; D011795:Surveys and Questionnaires; D013997:Time Factors