{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T10:58:43Z","timestamp":1790247523099,"version":"4.1.0"},"reference-count":49,"publisher":"Journal of Orthopaedic & Sports Physical Therapy (JOSPT)","issue":"3","content-domain":{"domain":["www.jospt.org"],"crossmark-restriction":true},"short-container-title":["Journal of Orthopaedic &amp; Sports Physical Therapy"],"published-print":{"date-parts":[[2019,3]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p> Following anterior cruciate ligament reconstruction (ACLR), young athletes demonstrate deficits in knee function and strength whose association with successful return to preinjury sports participation is not well understood. <\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p> To examine differences in knee function and strength at the time of return-to-sport clearance between young athletes who successfully resumed preinjury sports participation, those who did not resume preinjury sports participation, and those who sustained a second anterior cruciate ligament (ACL) injury by 1 year following return-to-sport clearance. <\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p> This prospective cohort study collected data in 124 young athletes (mean \u00b1 SD age, 17.1 \u00b1 2.4 years) at the time of return-to-sport clearance post ACLR. Measures included the Knee injury and Osteoarthritis Outcome Score (KOOS), single-leg hop tests, isokinetic quadriceps and hamstring strength, and limb symmetry during hop tests and strength tests. Participants were allocated to 3 groups: resumed preinjury sports participation (Tegner score), did not resume preinjury sports participation, or sustained a second ACL injury. Group differences were compared using Kruskal-Wallis tests and Mann-Whitney U post hoc tests. <\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p> Seventy (56%) participants successfully resumed preinjury sports participation and 26 (21%) sustained a second ACL injury by 1 year post return-to-sport clearance. Participants who successfully resumed preinjury sports participation demonstrated greater absolute performance at return-to-sport clearance in the involved and uninvolved limbs on the triple hop (P = .007 and P = .004, respectively) and the crossover hop (P = .033 and P = .037, respectively), and in the involved limb on the single hop (P = .043), compared to those who did not (n = 28). Participants who sustained a second ACL injury demonstrated greater absolute performance at return-to-sport clearance in the involved and uninvolved limbs on the triple hop (P = .034 and P = .027, respectively) compared to those who did not resume preinjury sports participation. There were no group differences between those who successfully resumed preinjury levels of sports participation and those who sustained a second ACL injury. <\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p> Following ACLR, the small proportion of young athletes who successfully resumed preinjury levels of sports participation 1 year after return to sport demonstrated greater absolute functional performance at the time of return-to-sport clearance. No differences were identified between those who successfully resumed preinjury sports participation and those who sustained a second ACL injury. Measures of limb symmetry did not differ among any of the groups. <\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p> Prognosis, level 2b. 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