{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,21]],"date-time":"2026-06-21T21:48:30Z","timestamp":1782078510188,"version":"3.54.5"},"reference-count":0,"publisher":"SAGE Publications","issue":"6_suppl5","license":[{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"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":["Orthopaedic Journal of Sports Medicine"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Recovery from anterior cruciate ligament reconstruction (ACLR), common in adolescent athletes, requires restoration of knee strength, stability, and range of motion prior to return-to-sport (RTS) clearance. RTS protocols incorporate strength and functional testing with patient-reported outcome measures (PROMs) to assess readiness. However, females report lower RTS readiness and lower RTS rates (37%) compared to males (52%) (Webster, 2018; Kostyun, 2021). Understanding sex-based differences in RTS testing is essential for optimizing rehabilitation and outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Hypothesis:<\/jats:title>\n                    <jats:p>Sex based differences exist in RTS testing metrics following ACLR in adolescent athletes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A retrospective chart review was conducted on 69 (37M, 32F) patients, aged 13-20y, who underwent primary ACL-R and RTS testing. Eighty-eight RTS tests were completed at 6 months (n=44) or 9 months (n=44) post-operatively; 19 patients tested at both time points. Exclusions included multi-ligament injuries, revision ACL, outside surgeries, and extreme outliers (&gt; 3 SD). Patients were grouped by sex and subdivided by RTS testing interval (6- or 9-months post-op) for comparisons. Physical RTS measures included limb symmetry index (LSI) of quadriceps and hamstring strength, Y-balance composite, and single-leg hop scores. PROM consisted of the ACL-Return to Sport after Injury (ACL-RSI) scale. Passing threshold was defined as \u226590% on physical metrics and \u226580% on ACL-RSI. Fisher\u2019s exact test (\u03b1 = 0.05) was used to compare the proportion of patients meeting RTS passing criteria between sexes and across time points.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Passing rates for quadriceps and hamstring strength, hop tests, and balance assessments were low at 6 months post-op but improved by 9-months in both sexes (Table 1). Males consistently demonstrated higher passing rates across all RTS metrics and timepoints (Figure 1). Overall, only 44.2% of patients passed quadriceps strength testing and 50% of patients passed the ACL-RSI at 9-month post-op. Males had significant differences passing quadriceps testing (p =.002) and ACL-RSI (p =.041) between 6 and 9-months. The proportion of males passing ACL-RSI was significantly higher (p =.031) than females 9 months post-op.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Identifying sex-based differences in RTS metrics can help specialize RTS rehabilitation and improve outcomes for adolescent athletes post-ACLR. The quadriceps strength and ACL-RSI passing rate for males is double that of females while reporting similar averages between patients who passed those metrics. Overall, nearly 50% of patients did not meet passing criteria in quadriceps strength and ACL-RSI at 9 months post-op, suggesting that this standard timepoint used for RTS criteria may be too early for many patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/2325967126s00106","type":"journal-article","created":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T17:26:17Z","timestamp":1781717177000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Females Meet Return to Sport Criteria at Lower Rates Than Males 9 Months After ACL Reconstruction"],"prefix":"10.1177","volume":"14","author":[{"given":"Samantha","family":"Collins","sequence":"first","affiliation":[{"name":"Children\u2019s National Hospital, Washington DC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mia","family":"Caminita","sequence":"additional","affiliation":[{"name":"Children\u2019s National Hospital, Washington DC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin","family":"McGuiness","sequence":"additional","affiliation":[{"name":"Children\u2019s National Hospital, Washington DC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samantha","family":"Allen","sequence":"additional","affiliation":[{"name":"Children\u2019s National Hospital, Washington DC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bashir","family":"Lamptey","sequence":"additional","affiliation":[{"name":"Children\u2019s National Hospital, Washington DC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chelsey","family":"Bowman","sequence":"additional","affiliation":[{"name":"Cildren\u2019s National Hospital, Washington DC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily","family":"Niu","sequence":"additional","affiliation":[{"name":"Children\u2019s National Hospital, Washington DC"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,6,17]]},"container-title":["Orthopaedic Journal of Sports Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/2325967126S00106","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/2325967126S00106","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,21]],"date-time":"2026-06-21T21:32:51Z","timestamp":1782077571000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/2325967126S00106"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6]]},"references-count":0,"journal-issue":{"issue":"6_suppl5","published-print":{"date-parts":[[2026,6]]}},"alternative-id":["10.1177\/2325967126S00106"],"URL":"https:\/\/doi.org\/10.1177\/2325967126s00106","relation":{},"ISSN":["2325-9671","2325-9671"],"issn-type":[{"value":"2325-9671","type":"print"},{"value":"2325-9671","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6]]},"article-number":"2325967126S00106"}}