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Motion capture offers gold-standard accuracy but requires specialized infrastructure and controlled environments; inertial measurement units are portable but often degrade due to sensor displacement under intense motion. Fabric sensors are comfortable and stable, yet existing single-plane designs cannot reliably separate the main flexion from coupled multi-plane motion. We present RTSense, the first fabric-based system capable of accurately estimating knee flexion during high-dynamic RTS tasks. RTSense places multiple fabric sensors in a cross-plane layout to capture complementary biomechanical cues, addressing two key challenges: fabric data distribution shifts and the bio-structural coupling of multi-plane knee motion. Building on this layout, RTSense combines a fabric-specific data augmentation framework to handle inter-subject and intra-subject variability with a disentangling model that leverages cross-plane features to recover knee flexion angles. To validate RTSense, we collaborate with a medical center and collect data from 35 participants, including ACL patients and healthy controls across athlete and non-athlete groups. RTSense achieves an average RMSE of 3.96\u00b0 for knee flexion, 3.71\u00b0 for peak flexion, and yields 100% correct RTS decisions, demonstrating its potential to support reliable RTS decision-making.<\/jats:p>","DOI":"10.1145\/3789686","type":"journal-article","created":{"date-parts":[[2026,3,16]],"date-time":"2026-03-16T17:51:14Z","timestamp":1773683474000},"page":"1-24","update-policy":"https:\/\/doi.org\/10.1145\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["RTSense: A Fabric-based Wearable System for Return-To-Sport Assessment of Anterior Cruciate Ligament Injuries"],"prefix":"10.1145","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5673-1409","authenticated-orcid":false,"given":"Xinyi","family":"Zhang","sequence":"first","affiliation":[{"name":"Computer Science and Engineering, HKUST, Hong Kong, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3031-2668","authenticated-orcid":false,"given":"Baichen","family":"Yang","sequence":"additional","affiliation":[{"name":"Computer Science and Engineering, HKUST, Hong Kong, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1115-7850","authenticated-orcid":false,"given":"Jiaxi","family":"Zhang","sequence":"additional","affiliation":[{"name":"Computer Science and Engineering, HKUST, Hong Kong, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1220-8816","authenticated-orcid":false,"given":"Xin","family":"He","sequence":"additional","affiliation":[{"name":"The Chinese University of Hong Kong, Hong Kong, Hong Kong"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-9766-6944","authenticated-orcid":false,"given":"Zuru","family":"Liang","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics &amp; Traumatology, The Chinese University of Hong Kong, Hong Kong, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2250-1549","authenticated-orcid":false,"given":"Qijia","family":"Shao","sequence":"additional","affiliation":[{"name":"Division of Integrative Systems and Design, The Hong Kong University of Science and Technology, Hong Kong, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4460-9286","authenticated-orcid":false,"given":"Tim-yun, Michael","family":"Ong","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics &amp; Traumatology, the Chinese University of Hong Kong, Hong Kong, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7214-5503","authenticated-orcid":false,"given":"Shu-hang, Patrick","family":"Yung","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics &amp; Traumatology, the Chinese University of Hong Kong, Hong Kong, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9205-1881","authenticated-orcid":false,"given":"Qian","family":"Zhang","sequence":"additional","affiliation":[{"name":"Computer Science and Engineering, HKUST, Hong Kong, Hong Kong"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"320","published-online":{"date-parts":[[2026,3,16]]},"reference":[{"key":"e_1_2_1_1_1","unstructured":"2025. 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