{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,5]],"date-time":"2026-11-05T19:11:07Z","timestamp":1793905867307,"version":"4.8.0"},"reference-count":20,"publisher":"Journal of Orthopaedic & Sports Physical Therapy (JOSPT)","issue":"5","content-domain":{"domain":["www.jospt.org"],"crossmark-restriction":true},"short-container-title":["Journal of Orthopaedic &amp; Sports Physical Therapy"],"published-print":{"date-parts":[[2017,5]]},"abstract":"<jats:sec>\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>Prospective cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The high risk of second anterior cruciate ligament (ACL) injuries after return to sport highlights the importance of return-to-sport decision making. Objective return-to-sport criteria frequently use limb symmetry indexes (LSIs) to quantify quadriceps strength and hop scores. Whether using the uninvolved limb in LSIs is optimal is unknown.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To evaluate the uninvolved limb as a reference standard for LSIs utilized in return-to-sport testing and its relationship with second ACL injury rates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Seventy athletes completed quadriceps strength and 4 single-leg hop tests before anterior cruciate ligament reconstruction (ACLR) and 6 months after ACLR. Limb symmetry indexes for each test compared involved-limb measures at 6 months to uninvolved-limb measures at 6 months. Estimated preinjury capacity (EPIC) levels for each test compared involved-limb measures at 6 months to uninvolved-limb measures before ACLR. Second ACL injuries were tracked for a minimum follow-up of 2 years after ACLR.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Forty (57.1%) patients achieved 90% LSIs for quadriceps strength and all hop tests. Only 20 (28.6%) patients met 90% EPIC levels (comparing the involved limb at 6 months after ACLR to the uninvolved limb before ACLR) for quadriceps strength and all hop tests. Twenty-four (34.3%) patients who achieved 90% LSIs for all measures 6 months after ACLR did not achieve 90% EPIC levels for all measures. Estimated preinjury capacity levels were more sensitive than LSIs in predicting second ACL injuries (LSIs, 0.273; 95% confidence interval [CI]: 0.010, 0.566 and EPIC, 0.818; 95% CI: 0.523, 0.949).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Limb symmetry indexes frequently overestimate knee function after ACLR and may be related to second ACL injury risk. These findings raise concern about whether the variable ACL return-to-sport criteria utilized in current clinical practice are stringent enough to achieve safe and successful return to sport.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>Prognosis, 2b. J Orthop Sports Phys Ther 2017;47(5):334\u2013338. Epub 29 Mar 2017. doi:10.2519\/jospt.2017.7285<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2519\/jospt.2017.7285","type":"journal-article","created":{"date-parts":[[2017,3,29]],"date-time":"2017-03-29T23:31:14Z","timestamp":1490830274000},"page":"334-338","update-policy":"https:\/\/doi.org\/10.2519\/jospt.crossmarkpolicy","source":"Crossref","is-referenced-by-count":463,"title":["Limb Symmetry Indexes Can Overestimate Knee Function After Anterior Cruciate Ligament Injury"],"prefix":"10.2519","volume":"47","author":[{"given":"Elizabeth","family":"Wellsandt","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mathew J.","family":"Failla","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lynn","family":"Snyder-Mackler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1394","reference":[{"key":"bib1","doi-asserted-by":"publisher","DOI":"10.2519\/jospt.2012.3871"},{"key":"bib2","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2013-093398"},{"key":"bib3","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2011.09.009"},{"key":"bib4","doi-asserted-by":"publisher","DOI":"10.1177\/036354659402200511"},{"key":"bib5","doi-asserted-by":"publisher","DOI":"10.1123\/jsr.6.3.246"},{"key":"bib6","doi-asserted-by":"publisher","DOI":"10.2519\/jospt.2010.3345"},{"key":"bib7","doi-asserted-by":"publisher","DOI":"10.1177\/0363546516652594"},{"key":"bib8","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2016-096031"},{"key":"bib9","doi-asserted-by":"publisher","DOI":"10.1002\/jor.20754"},{"key":"bib11","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinbiomech.2007.01.009"},{"key":"bib12","doi-asserted-by":"publisher","DOI":"10.1177\/0363546507308190"},{"key":"bib13","doi-asserted-by":"publisher","DOI":"10.2519\/jospt.2011.3547"},{"key":"bib14","first-page":"596","volume":"9","author":"Myers BA","year":"2014","journal-title":"Int J Sports Phys Ther."},{"key":"bib15","doi-asserted-by":"publisher","DOI":"10.1177\/036354659101900518"},{"key":"bib16","doi-asserted-by":"publisher","DOI":"10.1016\/j.csm.2008.02.001"},{"key":"bib17","doi-asserted-by":"publisher","DOI":"10.1177\/0363546514530088"},{"key":"bib18","doi-asserted-by":"publisher","DOI":"10.2519\/jospt.2012.4194"},{"key":"bib19","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-011-1669-8"},{"key":"bib20","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.83B8.0831104"},{"key":"bib21","doi-asserted-by":"publisher","DOI":"10.2519\/jospt.1994.20.2.60"}],"container-title":["Journal of Orthopaedic &amp; Sports Physical Therapy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.jospt.org\/doi\/pdf\/10.2519\/jospt.2017.7285","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,8,26]],"date-time":"2024-08-26T10:00:28Z","timestamp":1724666428000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.jospt.org\/doi\/10.2519\/jospt.2017.7285"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,5]]},"references-count":20,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2017,5]]}},"alternative-id":["10.2519\/jospt.2017.7285"],"URL":"https:\/\/doi.org\/10.2519\/jospt.2017.7285","relation":{},"ISSN":["0190-6011","1938-1344"],"issn-type":[{"value":"0190-6011","type":"print"},{"value":"1938-1344","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,5]]},"assertion":[{"value":"2017-04-30","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}