Career Length and Injury Incidence After Anterior Cruciate Ligament Reconstruction in Major League Soccer Players

Background: Little is known about career length after anterior cruciate ligament (ACL) reconstruction in Major League Soccer (MLS), the top men’s professional soccer league in the United States. Further, it is unspecified whether athletes returning to soccer after ACL reconstruction are at a higher risk for injuries, beyond new knee injuries. Purpose: To examine career length and the incidence of lower extremity injuries in MLS athletes after ACL reconstruction in comparison with age-matched controls. Study Design: Cohort study; Level of evidence, 3. Methods: Injuries and athletic exposures (AEs; games and training sessions) were recorded in the HealtheAthlete database, the injury surveillance system of MLS. All athletes who had undergone ACL reconstruction and returned to MLS were identified and age-matched with controls. Multivariate analyses of variance were used to compare career length and percentage of regular/postseason games that athletes started, substituted, or did not play. Generalized linear model regressions were used to examine the injury risk. Results: Athletes in the ACL group had shorter careers (1.3 ± 1.3 years) than those in the control group (2.5 ± 1.3 years) ( P < .01), but while they were playing, athletes in the ACL group participated in a similar number of AEs as those in the control group (169.9 ± 129.0 vs 171.6 ± 124.9 AEs, respectively; P = .95). Athletes in the ACL group started fewer regular/postseason games (36.7% ± 34.3% vs 60.1% ± 33.8%, respectively; P < .01) and did not play in more regular/postseason games (47.4% ± 35.5% vs 31.0% ± 34.4%, respectively; P = .03) compared with those in the control group. The ACL group was not at a significantly greater risk for lower extremity injuries compared with the control group (relative risk, 0.87; 95% CI, 0.55-1.37). Conclusion: Although MLS athletes after ACL reconstruction are not at a greater risk for lower extremity injuries, this study suggests that they are not utilized in regular/postseason games as frequently and that their careers in MLS are shorter than age-matched controls. Further research is necessary to elucidate reasons for these athletes’ shortened MLS careers. This study supports the view of return to sport not as a single time point but as a continuum from return to participation to return to play and return to performance.

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Comparison of the Position-Matching and Position-Reproducing Tasks to Detect Deficits in Knee Position Sense After Reconstruction of the Anterior Cruciate Ligament

Journal of Sport Rehabilitation ◽

10.1123/jsr.2017-0275 ◽

2020 ◽

Vol 29 (1) ◽

pp. 87-92

Author(s):

Takuma Hoshiba ◽

Hiroki Nakata ◽

Yasuaki Saho ◽

Kazuyuki Kanosue ◽

Toru Fukubayashi

Keyword(s):

Anterior Cruciate Ligament ◽

Acl Reconstruction ◽

Sport Participation ◽

Cruciate Ligament ◽

Knee Extension ◽

Position Sense ◽

Matching Task ◽

Control Group ◽

Knee Position ◽

Anterior Cruciate

Context: Deficits in knee position sense following reconstruction of the anterior cruciate ligament (ACL) can delay an athlete’s return to sport participation and increase the risk of reinjury. Deficits in position sense postreconstruction have been evaluated using either a position-reproducing or position-matching task. Objective: The aim of our study was to combine both to determine which assessment would be more effective to identify deficits in knee position sense. Design: Longitudinal laboratory-based study. Participants: Eleven athletes (6 men and 5 women; mean age, 20.5 [1.2] y), who had undergone ACL reconstruction with an ipsilateral hamstring autograft, and 12 age-matched controls. Interventions: Position sense was evaluated at 6 and 12 months postreconstruction and once for the control group. In addition, peak isokinetic knee extension and flexion strength, at 60°/s and 180°/s, was assessed for the ACL reconstruction group to evaluate possible influences of muscle strength on knee joint position sense. Main Outcome Measures: The variables include the angular differences between the reference limb and indicator limb, and peak torque values of isokinetic knee extension and flexion. Results: Significant matching differences were identified at 6 months postsurgery on the position-matching task, but not at 12 months postsurgery. No significant between-group and within-subject differences were identified on the position-reproducing task. No significant matching errors were identified for the control group. There was no correlation between errors in position sense and maximum isokinetic strength. Conclusion: The position-matching task is more sensitive than the position-reproducing task to identify deficits in knee position sense over the first year following ACL reconstruction surgery.

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Gait Analysis and Knee Kinematics in Patients with Anterior Cruciate Ligament Rupture: Before and After Reconstruction

Applied Sciences ◽

10.3390/app10103378 ◽

2020 ◽

Vol 10 (10) ◽

pp. 3378

Author(s):

Dmitry Skvortsov ◽

Sergey Kaurkin ◽

Alexander Akhpashev ◽

Aljona Altukhova ◽

Alexander Troitskiy ◽

...

Keyword(s):

Anterior Cruciate Ligament ◽

Gait Analysis ◽

Acl Reconstruction ◽

Cruciate Ligament ◽

Surgical Reconstruction ◽

Control Group ◽

Cycle Duration ◽

Post Surgery ◽

Before And After ◽

Anterior Cruciate

The objective of the study was to evaluate the clinical, functional, and biomechanical symptoms in patients with anterior cruciate ligament (ACL) rupture before and after ACL reconstruction. The study enrolled 20 patients and 20 healthy subjects as controls. Walking biomechanics was assessed at three time points: before surgery and three months and a year or more after surgical reconstruction. Impact loads on both sides differed significantly from the respective values before surgery (p<0.05). Walking cycle duration decreased with time after surgery. On both sides (affected and unaffected), hip movement amplitudes were significantly smaller than in control (p<0.05). They remained so in the follow-up periods after the reconstruction. Before ACL reconstruction, the amplitude of the main flexion of the knee was significantly reduced both on the affected and unaffected sides. The amplitude gradually increased after the reconstruction, and a year post-surgery, it reached, on the operated side, the same values as in the control group. Complete functional recovery of the knee joint was not achieved within a year after the ACL surgical reconstruction. The remaining changes, however, were not clinically pronounced and could only be detected by instrumental gait analysis. The compensatory processes developed bilaterally, in both the hip and knee joints.

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Mesenchymal stromal cells and platelet-rich plasma promote tendon allograft healing in ovine anterior cruciate ligament reconstruction

Knee Surgery Sports Traumatology Arthroscopy ◽

10.1007/s00167-020-06392-9 ◽

2020 ◽

Author(s):

Adam T. Hexter ◽

Anita Sanghani-Kerai ◽

Nima Heidari ◽

Deepak M. Kalaskar ◽

Ashleigh Boyd ◽

...

Keyword(s):

Anterior Cruciate Ligament ◽

Acl Reconstruction ◽

Stromal Cells ◽

Femoral Tunnel ◽

Platelet Rich Plasma ◽

Cruciate Ligament ◽

Control Group ◽

Tendon Allograft ◽

Tunnel Diameter ◽

Anterior Cruciate

Abstract Purpose The effect of bone marrow mesenchymal stromal cells (BMSCs) and platelet-rich plasma (PRP) on tendon allograft maturation in a large animal anterior cruciate ligament (ACL) reconstruction model was reported for the first time. It was hypothesised that compared with non-augmented ACL reconstruction, BMSCs and PRP would enhance graft maturation after 12 weeks and this would be detected using magnetic resonance imaging (MRI). Methods Fifteen sheep underwent unilateral tendon allograft ACL reconstruction using aperture fixation and were randomised into three groups (n = 5). Group 1 received 10 million allogeneic BMSCs in 2 ml fibrin sealant; Group 2 received 12 ml PRP in a plasma clot injected into the graft and bone tunnels; and Group 3 (control) received no adjunctive treatment. At autopsy at 12 weeks, a graft maturation score was determined by the sum for graft integrity, synovial coverage and vascularisation, graft thickness and apparent tension, and synovial sealing at tunnel apertures. MRI analysis (n = 2 animals per group) of the signal–noise quotient (SNQ) and fibrous interzone (FIZ) was used to evaluate intra-articular graft maturation and tendon–bone healing, respectively. Spearman’s rank correlation coefficient (r) of SNQ, autopsy graft maturation score and bone tunnel diameter were analysed. Results The BMSC group (p = 0.01) and PRP group (p = 0.03) had a significantly higher graft maturation score compared with the control group. The BMSC group scored significantly higher for synovial sealing at tunnel apertures (p = 0.03) compared with the control group. The graft maturation score at autopsy significantly correlated with the SNQ (r = − 0.83, p < 0.01). The tunnel diameter of the femoral tunnel at the aperture (r = 0.883, p = 0.03) and mid-portion (r = 0.941, p = 0.02) positively correlated with the SNQ. Conclusions BMSCs and PRP significantly enhanced graft maturation, which indicates that orthobiologics can accelerate the biologic events in tendon allograft incorporation. Femoral tunnel expansion significantly correlated with inferior maturation of the intra-articular graft. The clinical relevance of this study is that BMSCs and PRP enhance allograft healing in a translational model, and biological modulation of graft healing can be evaluated non-invasively using MRI.

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The Influence of Anterior Cruciate Ligament Remnant on Postoperative Clinical Results in Patients with Remnant Preserving Anterior Cruciate Ligament Reconstruction

Open Access Macedonian Journal of Medical Sciences ◽

10.3889/oamjms.2017.096 ◽

2017 ◽

Vol 5 (5) ◽

pp. 624-629 ◽

Cited By ~ 4

Author(s):

Alan Goce Andonovski ◽

Sonja Topuzovska ◽

Milan Samardziski ◽

Zoran Bozinovski ◽

Biljana Andonovska ◽

...

Keyword(s):

Anterior Cruciate Ligament ◽

Acl Reconstruction ◽

Cruciate Ligament ◽

Clinical Results ◽

Control Group ◽

Single Bundle ◽

Knee Stability ◽

The Mean ◽

Anterior Cruciate ◽

Proprioceptive Function

BACKGROUND: Anterior Cruciate Ligament (ACL) remnants have important biomechanical, vascular and proprioceptive function.AIM: To determine the influence of the ACL residual remnants after partial and complete ACL ruptures on postoperative clinical results in patients with remnant preserving ACL reconstruction.PATIENTS AND METHODS: The study included 66 patients divided into two groups. In patients from the investigation group remnant preserving ACL reconstruction was performed, in patients from the control group single bundle ACL reconstruction was performed. The results were assessed by Rolimeter measurements, Lysholm and Tegner scores and proprioception evaluation.RESULTS: The mean side-to-side difference of anterior tibia displacement (mm) was improved from 4.4 ± 1.06 to 0.4 ± 0.7 in the investigation group, and from 4.6 ± 0.68 to 1.9 ± 0.64 in the control group (p < 0.001). Difference in the angles in which the knee was placed by the device and the patient has improved from 1.5 ± 0.96° to 0.5 ± 0.53° in the investigation group and from 1.8 ± 0.78° to 1.3 ± 0.97° in the control group (p < 0.05). Tegner and Lysholm scores showed no difference between the groups.CONCLUSION: Preservation of the ACL residual bundle provides a better knee stability and proprioceptive function.

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Return to Play and Career Length After Anterior Cruciate Ligament Reconstruction Among Canadian Professional Football Players

The American Journal of Sports Medicine ◽

10.1177/0363546520918224 ◽

2020 ◽

Vol 48 (7) ◽

pp. 1682-1688

Author(s):

Robert Longstaffe ◽

Jeff Leiter ◽

Tanner Gurney-Dunlop ◽

Robert McCormack ◽

Peter MacDonald

Keyword(s):

Anterior Cruciate Ligament ◽

Acl Reconstruction ◽

Cruciate Ligament ◽

Return To Play ◽

Football Players ◽

Professional Football ◽

Collateral Ligament ◽

Career Length ◽

Anterior Cruciate ◽

Negative Predictor

Background: For many athletes, a tear of the anterior cruciate ligament (ACL) represents a significant injury that requires a prolonged period away from the sport with substantial rehabilitation. Hypothesis: There will be no difference in return to play (RTP) and career length after hamstring tendon (HT) ACL reconstruction in a group of Canadian Football League professional players as compared with what has been already been reported in the literature among professional football players. Study Design: Case-control study; Level of evidence, 3. Methods: Data on athletes who sustained an ACL injury were collected by team physicians and head athletic trainers from 2002 to 2017 from 2 Canadian Football League teams. Patient details included age at the time of injury, initial injury date, position, practice versus game injury, and primary versus rerupture with injury-specific data, such as affected limb, concomitant injuries, graft choice, and procedure performed. RTP rates and career length data were collected through publically available internet sources. Comparisons between the non-RTP and RTP groups were made with independent-sample t tests. Binomial logistic regression was performed to determine variables (ie, games preinjury, graft type, meniscal injury, collateral ligament injury) that contributed to players not being able to RTP. Results: A total of 44 ACL reconstructions were performed over the study period (HT, n = 32 [72.7%]; bone–patellar tendon–bone [BPTB], n = 8 [18.2%]; allograft, n = 4 [9.1%]). Overall, 69.8% (n = 30) were able to RTP in at least 1 game, while 30.2% (n = 13) did not return. Mean time to return was 316.1 days (range, 220-427 days), or 10.4 months. For those players who did RTP, mean career length after ACL reconstruction was 2.8 seasons, or 34.4 games. The majority (56.8%) of injuries occurred early in the season. Breakdown by graft type demonstrated RTP rates among HT, BPTB, and allograft of 64.5% (n = 20), 87.5% (n = 7), and 75% (n = 3), respectively. Career length among HT, BPTB, and allograft was 2.9, 2.4, and 3 seasons. Logistic regression analysis found only concomitant medial collateral ligament (MCL) injuries to be a negative predictor for RTP. Meniscal injuries were associated with a decreased RTP rate and career length, but this was not statistically significant. Conclusion: The RTP rates after ACL reconstruction in this study are similar to those reported in National Football League players. A concomitant injury to the MCL injury was a negative predictor of RTP. Meniscal injuries demonstrated a trend for decreased RTP rate and career length, but this was not a significant predictor. A large portion of injuries occur early in the season, and further study should be done to examine potential preventative strategies to reduce ACL injuries.

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Vancomycin Presoaking of the Graft Appears to Prevent Infection After Anterior Cruciate Ligament Reconstruction: A Systematic Review and Meta-analysis

HSS Journal ® ◽

10.1177/15563316211011682 ◽

2021 ◽

pp. 155633162110116

Author(s):

Francisco Figueroa ◽

David Figueroa ◽

Rafael Calvo ◽

Alex Vaisman ◽

Marilaura Nuñez ◽

...

Keyword(s):

Systematic Review ◽

Anterior Cruciate Ligament ◽

Acl Reconstruction ◽

Cruciate Ligament ◽

Meta Analysis ◽

Case Series ◽

Control Group ◽

Infection Rates ◽

Reconstruction Methods ◽

Anterior Cruciate

Background: Vancomycin presoaking of the graft has been shown to decrease infection rates in some case series of anterior cruciate ligament (ACL) reconstruction. Purpose: We sought to substantiate the efficacy of vancomycin presoaked grafts for the prevention of infection after ACL reconstruction. Methods: We performed a systematic review of Medline and OVID to assess the incidence of postoperative infection in studies comparing patients undergoing ACL reconstruction with the use of vancomycin presoaked ACL grafts and a control group of patients undergoing ACL reconstruction without the use of presoaked grafts. The efficacy of vancomycin presoaking was calculated using the Agresti-Coull confidence interval. Relative risk (RR) was calculated for every study and the total sample. Results: The 11 studies that met inclusion criteria comprised 24,298 patients. In patients with vancomycin presoaking of the graft, 1 infection was reported in 8764 cases (0.01% rate). In the studies with control groups that did not have vancomycin presoaked grafts, there were 125 infections in 15,534 ACL reconstructions (0.8% rate). The efficacy of vancomycin presoaking in preventing infection after ACL reconstruction was 99.9% (0.999%–1.000% CI). The overall RR obtained was 0.07 (0.03–0.16 CI). All included studies were retrospective cohort studies (level III). Conclusions: Vancomycin presoaking of the graft has been shown to decrease infection rates after ACL reconstruction in studies of low evidence level. This suggests the need for prospective randomized controlled trials addressing this issue so that recommendations on the routine use of vancomycin presoaking of ACL grafts can be made with confidence.

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Reducing Intra-Articular Haemarthrosis After Arthroscopic Anterior Cruciate Ligament Reconstruction

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967114s00136 ◽

2014 ◽

Vol 2 (11_suppl3) ◽

pp. 2325967114S0013

Author(s):

Fatih Karaaslan ◽

Sinan Karaoğlu ◽

Musa Uğur Mermerkaya

Keyword(s):

Anterior Cruciate Ligament ◽

Blood Loss ◽

Anterior Cruciate Ligament Reconstruction ◽

Acl Reconstruction ◽

Ligament Reconstruction ◽

Cruciate Ligament ◽

Control Group ◽

Double Blind Study ◽

Cruciate Ligament Reconstruction ◽

Anterior Cruciate

Objectives: A significant proportion of surgeons use intra-articular drains after arthroscopic anterior cruciate ligament (ACL) reconstruction. Haemarthrosis and pain adversely affects the functional outcome of ACL reconstruction. The purpose of the study was to evaluate the effect of tranexamic acid (TXA) administration to minimize pain and stiffness of knee joint by reducing haemarthrosis. Methods: The study enrolled 123 patients who underwent arthroscopic anterior cruciate ligament reconstruction in a prospective, randomized, double-blind study. The patients who were randomized into the TXA group (71 patients) received both intravenous and intra-articular TXA. The control group (52 patients) did not receive TXA. The anesthetist, surgeon, and observer were blinded to the study group (double-blinded). TXA was administered as a bolus dose of 15 mg/kg 10 minutes before the inflation of the tourniquet on the first side. This was followed by continued intra-articular administration of 3 g at 10 minutes before the deflation of the tourniquet. Intravenous infusion of 10 mg/kg/h was continued for the next 3 hours. Equal volumes of placebo were administered at the same rate and by the same route. We measured volume of drained blood 48 hours postoperatively. Results: The mean (± SD) postoperative volume of blood loss from the drain in the TXA and control groups was 100.6 ± 72mL and 164.3 ± 75mL ml, respectively. The difference between the two groups was significant (p < 0.005). Conclusion: This prospective randomized study showed that during arthroscopic anterior cruciate ligament reconstruction, TXA reduced blood loss and helped to reduce haemarthrosis amount and frequency with negligible side effects. With regard to the administration route, combined intravenous–intra-articular administration of TXA significantly reduces blood loss and the need for puncturing associated with arthroscopic anterior cruciate ligament reconstruction without enhancing the risk of deepssssssahrombosis.

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Validation of a Composite Test for Assessment of Readiness for Return to Sports After Anterior Cruciate Ligament Reconstruction: The K-STARTS Test

Sports Health A Multidisciplinary Approach ◽

10.1177/1941738118786454 ◽

2018 ◽

Vol 10 (6) ◽

pp. 515-522 ◽

Cited By ~ 2

Author(s):

William G. Blakeney ◽

Hervé Ouanezar ◽

Isabelle Rogowski ◽

Gregory Vigne ◽

Meven Le Guen ◽

...

Keyword(s):

Anterior Cruciate Ligament ◽

Acl Reconstruction ◽

Cruciate Ligament ◽

Intraclass Correlation ◽

Control Group ◽

Diagnostic Study ◽

Return To Sports ◽

Sensitivity To Change ◽

Significant Difference ◽

Anterior Cruciate

Background: There is limited information on the appropriate timing of return to sports after anterior cruciate ligament (ACL) reconstruction. A composite test was developed to assess the athlete’s ability to return to sports after ACL reconstruction: the Knee Santy Athletic Return To Sport (K-STARTS) test. Hypothesis: The K-STARTS test meets validation criteria for an outcome score assessing readiness for return to sports after ACL reconstruction. Study Design: Diagnostic study. Level of Evidence: Level 3. Methods: A prospective comparative study identified 410 participants: 371 participants who had undergone ACL reconstruction and a control group of 39 healthy participants. The K-STARTS score is calculated as the sum of 7 tests (8 components), for a maximal value of 21 points. Construct validity, internal consistency, discriminant validity, and sensitivity to change were used to validate this new test. Results: The K-STARTS assessment showed a high completion rate (100%), high reproducibility (intraclass correlation coefficient, 0.87; coefficient of variation, 7.8%), and high sensitivity to change. There was moderate correlation with the ACL Return to Sports after Injury scale (ACL-RSI) and hop tests. There were no ceiling or floor effects. There was a significant difference between K-STARTS scores assessed at 6 and 8 months postoperatively (11.2 ± 2.7 vs 17.1 ± 3.2; P < 0.001). The K-STARTS score in the control group was significantly higher than that in the ACL reconstruction group (17.3 ± 2.1 and 13.7 ± 3.8, respectively; P < 0.001). Conclusion: The K-STARTS test is an objective outcome measure for functional improvement after ACL reconstruction. Clinical Relevance: It is important for the clinician to determine when return to sports is optimal after ACL reconstruction to reduce the current high risk of reinjury.

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Immediate and 6-week effects of wearing a knee sleeve following anterior cruciate ligament reconstruction: a cross-over laboratory and randomised clinical trial

BMC Musculoskeletal Disorders ◽

10.1186/s12891-021-04540-x ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Gisela Sole ◽

Peter Lamb ◽

Todd Pataky ◽

Stefan Klima ◽

Pierre Navarre ◽

...

Keyword(s):

Clinical Trial ◽

Anterior Cruciate Ligament ◽

Acl Reconstruction ◽

Cruciate Ligament ◽

Peak Torque ◽

Randomised Clinical Trial ◽

Trial Registration ◽

Control Group ◽

Anterior Cruciate ◽

Isokinetic Peak Torque

Abstract Background Rehabilitation following anterior cruciate ligament (ACL) reconstructions is based mainly on comprehensive progressive exercise programmes using a multi-dimensional approach. Elastic knee sleeves may be useful adjuncts to rehabilitation. The aim of this study was to determine the immediate and 6-week effects of wearing a knee sleeve on person-reported outcomes and function in participants who had undergone an ACL reconstruction and who had residual self-reported functional limitations. Methods Individuals with ACL reconstruction in the previous 6 months to 5 years were recruited. Immediate effects of a commercially-available elastic knee sleeve on single-leg horizontal hop distance were explored using a cross-over design. Following this first session, participants were randomised into a Control Group and a Sleeve Group who wore the sleeve for 6 weeks, at least 1 h daily. Outcome measures for the randomised clinical trial (RCT) were the International Knee Documentation Classification Subjective Knee Form (IKDC-SKF) score, the single-leg horizontal hop distance, and isokinetic quadriceps and hamstring peak torque. Linear mixed models were used to determine random effects. Where both limbs were measured at multiple time points, a random measurement occasion effect nested within participant was used. Results Thirty-four individuals (16 women) with ACL reconstruction completed the cross-over trial. Hop distance for the injured side during the sleeve condition increased by 3.6 % (95 % CI 0.4–6.8 %, p = 0.025). There was no evidence of differential changes between groups for the IKDC-SKF (Sleeve Group n = 15; Control Group n = 16; p = 0.327), or relative improvement in the injured side compared to the uninjured side for the physical performance measures (Sleeve Group n = 12, Control Group n = 12; three-way interaction p = 0.533 [hop distance], 0.381 [quadriceps isokinetic peak torque], and 0.592 [hamstring isokinetic peak torque]). Conclusions Single-leg hop distance of the ACL reconstructed side improved when wearing a knee sleeve. Wearing the knee sleeve over 6 weeks did not lead to enhanced improvements in self-reported knee function, hop distance and thigh muscle strength compared to the control group. Trial registration The trial was prospectively registered with the Australia New Zealand Clinical Trials Registry No: ACTRN12618001083280, 28 June 2018.

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Force Production and Reactive Strength Capabilities After Anterior Cruciate Ligament Reconstruction

Journal of Athletic Training ◽

10.4085/1062-6050-43.3.249 ◽

2008 ◽

Vol 43 (3) ◽

pp. 249-257 ◽

Cited By ~ 16

Author(s):

Eamonn P. Flanagan ◽

Lorcan Galvin ◽

Andrew J. Harrison

Keyword(s):

Anterior Cruciate Ligament ◽

Acl Reconstruction ◽

Repeated Measures ◽

Cruciate Ligament ◽

Reaction Force ◽

Force Production ◽

Limiting Factors ◽

Normative Values ◽

Control Group ◽

Anterior Cruciate

Abstract Context: Ambiguity exists in the literature regarding whether individuals can restore function to 100% after anterior cruciate ligament (ACL) reconstruction. The response of force production and reactive strength in stretch-shortening cycle activities after surgery has not been established. Objective: To compare reactive strength and force production capabilities between the involved and uninvolved legs of participants who had undergone ACL reconstruction and rehabilitation with the reactive strength and force production capabilities of a control group. Design: Repeated measures, cross-sectional. Setting: Research laboratory. Patients or Other Participants: Ten participants with ACL reconstructions who had returned to their chosen sports and 10 age-matched and activity-matched control subjects. Intervention(s): We screened the ACL group with the International Knee Documentation Committee Subjective Knee Evaluation Form and functional performance tests to measure a basic level of function. We assessed force production capabilities and reactive strength using squat, countermovement, drop, and rebound jump protocols on a force sledge apparatus. Main Outcome Measure(s): The dependent variables were flight time, peak vertical ground reaction force, leg spring stiffness, and reactive strength index. Results: No participant in the ACL group exhibited functional deficits in comparison with normative values or the control group. Using the force sledge apparatus, we found no notable differences in force production capabilities and reactive strength in the ACL group when comparing the involved with uninvolved legs or the degree of difference between legs with the control group. Conclusions: After ACL reconstruction, rehabilitated participants did not exhibit deficits in force production or reactive strength capabilities. Our results suggest that force production and reactive strength capabilities can be restored to levels comparable with the uninjured control limb and may not be limiting factors in ACL recovery.

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