Background
This retrospective study investigates functional fitness and return to sport (RTS) after anterior cruciate ligament (ACL) reconstruction at an acute care hospital. ACL injury often leads to functional knee impairment. Modern rehabilitation focuses on individualized, functional criteria rather than fixed time intervals to ensure a safe RTS.
Objective
What is the functional and psychological status of patients approximately 1 year postsurgery based on the Knee Injury and Osteoarthritis Outcome Score (KOOS), ACL-RSI (RSI: Return to Sport after Injury scale), and RTS tests? Which factors influence the return to sport?
Materials and methods
A total of 149 patients (aged 18-60) with isolated ACL reconstruction were retrospectively analyzed using KOOS, ACL-RSI, and a standardized test battery (including strength, jumping ability, and balance). The Limb Symmetry Index (LSI) with a 90% cut-off was used for functional assessment.
Results
Significant and clinically relevant improvements in pain, function, and psychological readiness were observed across all age groups, especially in sports participation and quality of life. Limited single-leg jumping performance, especially in middle adulthood, and functional deficits under fatigue proved to be key limiting factors for athletic performance. Return to sport was significantly influenced by subjective sports function and psychological readiness, which were strongly correlated (KOOS Sport-ACL-RSI: ρ = 0.56; p