🎯 Título: Las mujeres cumplen menos los criterios de retorno al deporte tras cirugía de LCA
📌 En breve: Nueve meses después de la reconstrucción de LCA, los hombres cumplieron los criterios de fuerza y preparación psicológica para volver al deporte con más del doble de frecuencia que las mujeres.
🔬 Puntos clave:
### El estudio
Revisión retrospectiva de 69 pacientes adolescentes (37 hombres, 32 mujeres, 13-20 años) que completaron pruebas de retorno al deporte a los 6 y/o 9 meses tras la reconstrucción de LCA, incluyendo fuerza de cuádriceps/isquiotibiales, equilibrio, salto y el cuestionario de preparación psicológica ACL-RSI.
### La diferencia por sexo
Los hombres tuvieron tasas de aprobación consistentemente más altas que las mujeres en todas las pruebas y momentos evaluados. A los 9 meses, la proporción de hombres que aprobó el ACL-RSI fue significativamente mayor que la de mujeres (p = 0,031).
### Un hallazgo que preocupa a ambos sexos
En conjunto, solo el 44,2% de todos los pacientes aprobó la prueba de fuerza de cuádriceps y solo el 50% aprobó el ACL-RSI a los 9 meses —sugiriendo que este plazo estándar podría ser demasiado temprano para muchos pacientes, no solo para las mujeres.
🎯 Aplicación clínica para LATAM: Programas de rehabilitación de LCA en la región deberían individualizar el momento del retorno al deporte según criterios objetivos cumplidos, en vez de un plazo fijo de 9 meses, prestando atención particular a la preparación psicológica y de fuerza en mujeres.
⚠ Limitaciones: La muestra fue pequeña (69 pacientes) y de un solo centro, y el diseño retrospectivo no permite establecer por qué existe esta diferencia entre sexos.
Background
Recovery from anterior cruciate ligament reconstruction (ACLR), common in adolescent athletes, requires restoration of knee strength, stability, and range of motion prior to return-to-sport (RTS) clearance. RTS protocols incorporate strength and functional testing with patient-reported outcome measures (PROMs) to assess readiness. However, females report lower RTS readiness and lower RTS rates (37%) compared to males (52%) (Webster, 2018; Kostyun, 2021). Understanding sex-based differences in RTS testing is essential for optimizing rehabilitation and outcomes.
Hypothesis
Sex based differences exist in RTS testing metrics following ACLR in adolescent athletes.
Methods
A retrospective chart review was conducted on 69 (37M, 32F) patients, aged 13-20y, who underwent primary ACL-R and RTS testing. Eighty-eight RTS tests were completed at 6 months (n=44) or 9 months (n=44) post-operatively; 19 patients tested at both time points. Exclusions included multi-ligament injuries, revision ACL, outside surgeries, and extreme outliers (> 3 SD). Patients were grouped by sex and subdivided by RTS testing interval (6- or 9-months post-op) for comparisons. Physical RTS measures included limb symmetry index (LSI) of quadriceps and hamstring strength, Y-balance composite, and single-leg hop scores. PROM consisted of the ACL-Return to Sport after Injury (ACL-RSI) scale. Passing threshold was defined as ≥90% on physical metrics and ≥80% on ACL-RSI. Fisher's exact test (α = 0.05) was used to compare the proportion of patients meeting RTS passing criteria between sexes and across time points.
Results
Passing rates for quadriceps and hamstring strength, hop tests, and balance assessments were low at 6 months post-op but improved by 9-months in both sexes (Table 1). Males consistently demonstrated higher passing rates across all RTS metrics and timepoints (Figure 1). Overall, only 44.2% of patients passed quadriceps strength testing and 50% of patients passed the ACL-RSI at 9-month post-op. Males had significant differences passing quadriceps testing (p =.002) and ACL-RSI (p =.041) between 6 and 9-months. The proportion of males passing ACL-RSI was significantly higher (p =.031) than females 9 months post-op.
Conclusion
Identifying sex-based differences in RTS metrics can help specialize RTS rehabilitation and improve outcomes for adolescent athletes post-ACLR. The quadriceps strength and ACL-RSI passing rate for males is double that of females while reporting similar averages between patients who passed those metrics. Overall, nearly 50% of patients did not meet passing criteria in quadriceps strength and ACL-RSI at 9 months post-op, suggesting that this standard timepoint used for RTS criteria may be too early for many patients.
Cómo citar:
Collins S, Caminita M, McGuiness K, Allen S, Lamptey B, Bowman C, Niu E. (2026).
Females Meet Return to Sport Criteria at Lower Rates Than Males 9 Months After ACL Reconstruction.. Orthopaedic journal of sports medicine.
DOI: 10.1177/2325967126s00106 ↗ PMID: 42333090 ↗ Acceso al paper: Ver completo ↗
