{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T16:46:36Z","timestamp":1789231596923,"version":"build-2803163510"},"reference-count":96,"publisher":"SAGE Publications","issue":"7","license":[{"start":{"date-parts":[[2026,1,23]],"date-time":"2026-01-23T00:00:00Z","timestamp":1769126400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Am J Sports Med"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Revision anterior cruciate ligament (ACL) reconstruction (ACLR) is a well-established procedure to restore knee stability and improve function after a failed primary ACLR. In active individuals, patient, injury, and operative variables influencing successful return to sport (RTS) after revision ACLR remain poorly understood.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Purpose:<\/jats:title>\n                    <jats:p>To evaluate RTS outcomes in patients undergoing revision ACLR.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design:<\/jats:title>\n                    <jats:p>Meta-analysis, Level of evidence, 4<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A systematic review was conducted in accordance with the 2020 PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. A literature search was conducted by querying 5 databases from inception through January 2025 to identify studies reporting on RTS outcomes in athletes undergoing revision ACLR. Meta-analysis was performed using random-effects models at 95% confidence intervals, with odds ratios used for comparative studies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      A total of 52 studies, consisting of 3814 patients, met inclusion criteria. The mean patient age was 27.6 \u00b1 8.4 years, with 66.3% (2340\/3532) of the patients being male. Soccer was the most commonly reported sport (24.6%; 390\/1584), followed by basketball (17.6%; 278\/1584) and football (7.8%; 124\/1584). The overall pooled RTS rate was 77.8% (95% CI, 0.732-0.824), with the RTS rate to the previous level of competition being 48.2% (95% CI, 0.410-0.553). The weighted mean time to RTS was 9.3 \u00b1 2.7 months. Patients undergoing revision ACLR with the addition of a lateral extra-articular procedure (LEAP) had a significantly higher RTS rate (90.6% vs 74.9%;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .00001), while greater articular cartilage damage was associated with less successful RTS (OR, 0.214; 95% CI, 0.078-0.584). The mean postoperative Anterior Cruciate Ligament Return to Sport after Injury score was 61.2 \u00b1 24.1 (n = 535). The most commonly reported reason for failure to RTS or RTS at a lower competition level was fear of reinjury (28.0%; 142\/508), followed by knee pain (12.0%; 61\/508) and persistent instability (7.3%; 37\/508).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>The overall RTS rate after revision ACLR was 77.8%, with 48.2% returning to the previous level of competition. The addition of a LEAP led to improved RTS rates. Fear of reinjury was reported as the most commonly reported barrier to successful RTS.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/03635465251405493","type":"journal-article","created":{"date-parts":[[2026,1,23]],"date-time":"2026-01-23T09:13:20Z","timestamp":1769159600000},"page":"1757-1770","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Return to Sport After Revision Anterior Cruciate Ligament Reconstruction: A Systematic Review and Meta-analysis"],"prefix":"10.1177","volume":"54","author":[{"given":"Varun","family":"Gopinatth","sequence":"first","affiliation":[{"name":"Saint Louis University School of Medicine, St. Louis, Missouri, USA"},{"name":"Department of Orthopaedic Surgery, Oregon Health and Science University, Portland, Oregon, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9558-8147","authenticated-orcid":false,"given":"Daniel C.","family":"Touhey","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Oregon Health and Science University, Portland, Oregon, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"III","given":"Edward M.","family":"Barksdale","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Washington University School of Medicine, St. Louis, Missouri, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Derrick M.","family":"Knapik","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Washington University School of Medicine, St. Louis, Missouri, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,1,23]]},"reference":[{"issue":"12","key":"e_1_3_2_2_2","article-title":"Comparison of revision ACL reconstruction using iliotibial band augmented with allograft versus bone\u2013patellar tendon\u2013bone autograft with lateral extra-articular tenodesis","volume":"11","author":"Abou Al","year":"2023","unstructured":"Abou Al, Ezz M, Gerometta A, Valentin E, et al. 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