Return to Play/Sport

Dr. Logan's Top 10 factors to assess on Return to Play testing following Complex Knee Surgery

1. Timing: Risk of early re-rupture is high in younger patients; I do not recommend RTS prior to 9 mos for most complex knee surgery.
2. RTS clearance is a multi-disciplinary decision: surgeon, physical therapist, athletic trainer, and may include mental health professionals.
3. RTS clearance is a mix of physical exam, RTS testing and psychological readiness.
4. Physical Exam: no pain, no effusion, full ROM, stable ligamentous test, thigh girth > 90% of the contralateral side. Bonus points for good ankle mobility.
5. Balance/Neuromuscular Control - my favorite tests: >90% contralateral side
6. Movement Quality: assess for dynamic valgus with single leg squats, drop jumps and countermovement jumps. Be sure to assess with multiple reps (effect of fatigue.
7. Observational, qualitative drop jump testing: (LESS/Landing Error Scoring System) - assess with fatigue
8. Agility - need a guide on the go, here is the Vail Sports Test: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3290923/#app
9. Mental Health - Assess with ACLR-RSI- never be afraid to encourage your athlete to seek help if you are concerned.
10. Finally, data is important. Not only does it help you make decisions about RTP, but it promotes buy-in from the patient to keep up with their programming!