{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,7]],"date-time":"2026-11-07T05:48:48Z","timestamp":1794030528841,"version":"4.8.0"},"reference-count":43,"publisher":"National Athletic Trainers' Association","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,4,1]]},"abstract":"<jats:sec>\n                  <jats:title>Context<\/jats:title>\n                  <jats:p>Return-to-activity (RTA) assessments are commonly administered after anterior cruciate ligament reconstruction (ACLR) to manage the patient's postoperative progressions back to activity. To date, few data are available on the clinical utility of these assessments to predict patient outcomes such as secondary anterior cruciate ligament (ACL) injury once the athlete has returned to activity.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>To identify the measures of patient function at 6 months post-ACLR that best predict RTA and second ACL injury at a minimum of 2 years after ACLR.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Design<\/jats:title>\n                  <jats:p>Prospective cohort study.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Setting<\/jats:title>\n                  <jats:p>Laboratory.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Patients or Other Participants<\/jats:title>\n                  <jats:p>A total of 234 patients with primary, unilateral ACLR completed functional assessments at approximately 6 months post-ACLR. Of these, 192 (82.1%) completed follow-up at \u22652 years post-ACLR.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Main Outcome Measure(s)<\/jats:title>\n                  <jats:p>The 6-month functional assessments consisted of patient-reported outcomes, isokinetic knee-flexor and -extensor strength, and single-legged hopping. We collected RTA and secondary ACL injury data at \u22652 years after ACLR.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Of the patients who were able to RTA (n = 155), 44 (28.4%) had a subsequent ACL injury, 24 (15.5%) to the ipsilateral graft ACL and 20 (12.9%) to the contralateral ACL. A greater proportion of females had a secondary injury to the contralateral ACL (15\/24, 62.5%), whereas a greater proportion of males reinjured the ipsilateral ACL graft (15\/20, 75.0%; P = .017). Greater knee-extension symmetry at 6 months increased the probability of reinjury (B = 0.016, P = .048). Among patients with RTA at &amp;lt;8 months, every 1% increase in quadriceps strength symmetry at 6 months increased the risk of reinjury by 2.1% (B = 0.021, P = .05). Among patients with RTA at &amp;gt;8 months, every month that RTA was delayed reduced the risk of reinjury by 28.4% (B = \u20130.284, P = .042). Descriptive statistics of patient function stratified between the early and delayed RTA groups can be found in the Supplemental Table (available online at http:\/\/dx.doi.org\/10.4085\/1062-6050-0407.20.S1).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Patients with more symmetric quadriceps strength at 6 months post-ACLR were more likely to experience another ACL rupture, especially those who returned to sport at &amp;lt;8 months after the index surgery. Clinicians should be cognizant that returning high-functioning patients to activity at &amp;lt;8 months post-ACLR may place them at an increased risk for reinjury.<\/jats:p>\n               <\/jats:sec>","DOI":"10.4085\/1062-6050-0407.20","type":"journal-article","created":{"date-parts":[[2021,6,15]],"date-time":"2021-06-15T19:30:56Z","timestamp":1623785456000},"page":"325-333","source":"Crossref","is-referenced-by-count":47,"title":["Predicting Anterior Cruciate Ligament Reinjury From Return-to-Activity Assessments at 6 Months Postsurgery: A Prospective Cohort Study"],"prefix":"10.4085","volume":"57","author":[{"given":"Stephan G.","family":"Bodkin","sequence":"first","affiliation":[{"name":"University of Colorado, Anschutz Medical Campus, Aurora"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jay","family":"Hertel","sequence":"additional","affiliation":[{"name":"University of Virginia, Charlottesville"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David R.","family":"Diduch","sequence":"additional","affiliation":[{"name":"University of Virginia, Charlottesville"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan A.","family":"Saliba","sequence":"additional","affiliation":[{"name":"University of Virginia, Charlottesville"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wendy M.","family":"Novicoff","sequence":"additional","affiliation":[{"name":"University of Virginia, Charlottesville"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen F.","family":"Brockmeier","sequence":"additional","affiliation":[{"name":"University of Virginia, Charlottesville"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark D.","family":"Miller","sequence":"additional","affiliation":[{"name":"University of Virginia, Charlottesville"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F. Winston","family":"Gwathmey","sequence":"additional","affiliation":[{"name":"University of Virginia, Charlottesville"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian C.","family":"Werner","sequence":"additional","affiliation":[{"name":"University of Virginia, Charlottesville"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph M.","family":"Hart","sequence":"additional","affiliation":[{"name":"University of Virginia, Charlottesville"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2557","published-online":{"date-parts":[[2021,6,15]]},"reference":[{"key":"2022041917473914800_i1938-162X-57-4-325-b01","doi-asserted-by":"crossref","unstructured":"Paterno\n              MV,\n            \n            \n              Huang\n              B,\n            \n            \n              Thomas\n              S,\n            \n            \n              Hewett\n              TE,\n            \n            \n              Schmitt\n         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Train.\n\t\t\t\t\t2017;\n\t\t\t\t\t52(9):\n\t\t\t\t\t847\u2013\n\t\t\t\t\t860.\n\t\t\t\t\tdoi:10.4085\/1062-6050.52.6.06","DOI":"10.4085\/1062-6050-52.6.06"},{"key":"2022041917473914800_i1938-162X-57-4-325-b28","doi-asserted-by":"crossref","unstructured":"Barrett\n              AM,\n            \n            \n              Craft\n              JA,\n            \n            \n              Replogle\n              WH,\n            \n            \n              Hydrick\n              JM,\n            \n            \n              Barrett\n              GR.\n            \n          \n          Anterior cruciate ligament graft failure: a comparison of graft type based on age and Tegner activity level.\n\t\t\t\t\tAm J Sports Med.\n\t\t\t\t\t2011;\n\t\t\t\t\t39(10):\n\t\t\t\t\t2194\u2013\n\t\t\t\t\t2198.\n\t\t\t\t\tdoi:10.1177\/0363546511415655","DOI":"10.1177\/0363546511415655"},{"key":"2022041917473914800_i1938-162X-57-4-325-b29","doi-asserted-by":"crossref","unstructured":"Mohtadi\n      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\n          \n          Incidence and risk factors for graft rupture and contralateral rupture after anterior cruciate ligament reconstruction.\n\t\t\t\t\tArthroscopy.\n\t\t\t\t\t2005;\n\t\t\t\t\t21(8):\n\t\t\t\t\t948\u2013\n\t\t\t\t\t957.\n\t\t\t\t\tdoi:10.1016\/j.arthro.2005.04.110","DOI":"10.1016\/j.arthro.2005.04.110"},{"key":"2022041917473914800_i1938-162X-57-4-325-b31","doi-asserted-by":"crossref","unstructured":"Paterno\n              MV,\n            \n            \n              Rauh\n              MJ,\n            \n            \n              Schmitt\n              LC,\n            \n            \n              Ford\n              KR,\n            \n            \n              Hewett\n              TE.\n            \n          \n          Incidence of contralateral and ipsilateral anterior cruciate ligament (ACL) injury after primary ACL reconstruction and return to sport.\n\t\t\t\t\tClin J Sport Med.\n\t\t\t\t\t2012;\n\t\t\t\t\t22(2):\n\t\t\t\t\t116\u2013\n\t\t\t\t\t121.\n\t\t\t\t\tdoi:10.1097\/JSM.0b013e318246ef9e","DOI":"10.1097\/JSM.0b013e318246ef9e"},{"key":"2022041917473914800_i1938-162X-57-4-325-b32","doi-asserted-by":"crossref","unstructured":"Bourke\n              HE,\n            \n            \n              Salmon\n              LJ,\n            \n            \n              Waller\n              A,\n            \n            \n              Patterson\n              V,\n            \n            \n              Pinczewski\n              LA.\n            \n          \n          Survival of the anterior cruciate ligament graft and the contralateral ACL at a minimum of 15 years.\n\t\t\t\t\tAm J Sports Med.\n\t\t\t\t\t2012;\n\t\t\t\t\t40(9):\n\t\t\t\t\t1985\u2013\n\t\t\t\t\t1992.\n\t\t\t\t\tdoi:10.1177\/0363546512454414","DOI":"10.1177\/0363546512454414"},{"key":"2022041917473914800_i1938-162X-57-4-325-b33","doi-asserted-by":"crossref","unstructured":"Grindem\n          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Part II: clinical application of a new test battery.\n\t\t\t\t\tKnee Surg Sports Traumatol Arthrosc.\n\t\t\t\t\t2015;\n\t\t\t\t\t23(5):\n\t\t\t\t\t1283\u2013\n\t\t\t\t\t1291.\n\t\t\t\t\tdoi:10.1007\/s00167-015-3546-3","DOI":"10.1007\/s00167-015-3546-3"},{"key":"2022041917473914800_i1938-162X-57-4-325-b35","doi-asserted-by":"crossref","unstructured":"Podlog\n              L,\n            \n            \n              Banham\n              SM,\n            \n            \n              Wadey\n              R,\n            \n            \n              Hannon\n              JC.\n            \n          \n          Psychological readiness to return to competitive sport following injury: a qualitative study.\n\t\t\t\t\tSport Psychol.\n\t\t\t\t\t2015;\n\t\t\t\t\t29(1):\n\t\t\t\t\t1\u2013\n\t\t\t\t\t14.\n\t\t\t\t\tdoi:10.1123\/tsp.2014-0063","DOI":"10.1123\/tsp.2014-0063"},{"key":"2022041917473914800_i1938-162X-57-4-325-b36","doi-asserted-by":"crossref","unstructured":"DiSanti\n              J,\n            \n            \n              Lisee\n              C,\n            \n            \n              Erickson\n              K,\n            \n            \n              Bell\n              D,\n            \n            \n              Shingles\n              M,\n            \n            \n              Kuenze\n              C.\n            \n          \n          Perceptions of rehabilitation and return to sport among high school athletes with anterior cruciate ligament reconstruction: a qualitative research study.\n\t\t\t\t\tJ Orthop Sports Phys Ther.\n\t\t\t\t\t2018;\n\t\t\t\t\t48(12):\n\t\t\t\t\t951\u2013\n\t\t\t\t\t959.\n\t\t\t\t\tdoi:10.2519\/jospt.2018.8277","DOI":"10.2519\/jospt.2018.8277"},{"key":"2022041917473914800_i1938-162X-57-4-325-b37","doi-asserted-by":"crossref","unstructured":"Pietrosimone\n              B,\n            \n            \n              Davis-Wilson\n              HC,\n            \n            \n              Seeley\n              MK,\n            \n            et al.\n\t\t\t\t\t\n          Gait biomechanics in individuals meeting sufficient quadriceps strength cutoffs following anterior cruciate ligament reconstruction.\n\t\t\t\t\tJ Athl Train.\n\t\t\t\t\t2021;\n\t\t\t\t\t56(9):\n\t\t\t\t\t960\u2013\n\t\t\t\t\t966.\n\t\t\t\t\tdoi:10.4085\/425-20","DOI":"10.4085\/425-20"},{"key":"2022041917473914800_i1938-162X-57-4-325-b38","doi-asserted-by":"crossref","unstructured":"Bodkin\n              S,\n            \n            \n              Goetschius\n              J,\n            \n            \n              Hertel\n              J,\n            \n            \n              Hart\n              J.\n            \n          \n          Relationships of muscle function and subjective knee function in patients after ACL reconstruction.\n\t\t\t\t\tOrthop J Sports Med.\n\t\t\t\t\t2017;\n\t\t\t\t\t5(7):\n\t\t\t\t\t2325967117719041.\n\t\t\t\t\tdoi:10.1177\/2325967117719041","DOI":"10.1177\/2325967117719041"},{"key":"2022041917473914800_i1938-162X-57-4-325-b39","doi-asserted-by":"crossref","unstructured":"Della Villa\n              F,\n            \n            \n              Straub\n              RK,\n            \n            \n              Mandelbaum\n              B,\n            \n            \n              Powers\n              CM.\n            \n          \n          Confidence to return to play after anterior cruciate ligament reconstruction is influenced by quadriceps strength symmetry and injury mechanism.\n\t\t\t\t\tSports Health.\n\t\t\t\t\t2021;\n\t\t\t\t\t13(3):\n\t\t\t\t\t304\u2013\n\t\t\t\t\t309.\n\t\t\t\t\tdoi:10.1177\/1941738120976377","DOI":"10.1177\/1941738120976377"},{"key":"2022041917473914800_i1938-162X-57-4-325-b40","doi-asserted-by":"crossref","unstructured":"Nagelli\n              CV,\n            \n            \n              Hewett\n              TE.\n            \n          \n          Should return to sport be delayed until 2 years after anterior cruciate ligament reconstruction? Biological and functional considerations.\n\t\t\t\t\tSports Med.\n\t\t\t\t\t2017;\n\t\t\t\t\t47(2):\n\t\t\t\t\t221\u2013\n\t\t\t\t\t232.\n\t\t\t\t\tdoi:10.1007\/s40279-016-0584-z","DOI":"10.1007\/s40279-016-0584-z"},{"key":"2022041917473914800_i1938-162X-57-4-325-b41","doi-asserted-by":"crossref","unstructured":"Webster\n              KE,\n            \n            \n              Hewett\n              TE.\n            \n          \n          What is the evidence for and validity of return-to-sport testing after anterior cruciate ligament reconstruction surgery? A systematic review and meta-analysis.\n\t\t\t\t\tSports Med.\n\t\t\t\t\t2019;\n\t\t\t\t\t49(6):\n\t\t\t\t\t917\u2013\n\t\t\t\t\t929.\n\t\t\t\t\tdoi:10.1007\/s40279-019-01093-x","DOI":"10.1007\/s40279-019-01093-x"},{"key":"2022041917473914800_i1938-162X-57-4-325-b42","doi-asserted-by":"crossref","unstructured":"Hewett\n              TE,\n            \n            \n              Webster\n              KE,\n            \n            \n              Hurd\n              WJ.\n            \n          \n          Systematic selection of key logistic regression variables for risk prediction analyses: a five-factor maximum model.\n\t\t\t\t\tClin J Sport Med.\n\t\t\t\t\t2019;\n\t\t\t\t\t29(1):\n\t\t\t\t\t78\u2013\n\t\t\t\t\t85.\n\t\t\t\t\tdoi:10.1097\/JSM.0000000000000486","DOI":"10.1097\/JSM.0000000000000486"},{"key":"2022041917473914800_i1938-162X-57-4-325-b43","doi-asserted-by":"crossref","unstructured":"Pietrosimone\n              B,\n            \n            \n              Lepley\n              AS,\n            \n            \n              Harkey\n              MS,\n            \n            et al.\n\t\t\t\t\t\n          Quadriceps strength predicts self-reported function post-ACL reconstruction.\n\t\t\t\t\tMed Sci Sports Exerc.\n\t\t\t\t\t2016;\n\t\t\t\t\t48(9):\n\t\t\t\t\t1671\u2013\n\t\t\t\t\t1677.\n\t\t\t\t\tdoi:10.1249\/mss.0000000000000946","DOI":"10.1249\/MSS.0000000000000946"}],"container-title":["Journal of Athletic Training"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/meridian.allenpress.com\/jat\/article-pdf\/57\/4\/325\/3046571\/i1938-162x-57-4-325.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/meridian.allenpress.com\/jat\/article-pdf\/57\/4\/325\/3046571\/i1938-162x-57-4-325.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,6,11]],"date-time":"2025-06-11T19:02:14Z","timestamp":1749668534000},"score":1,"resource":{"primary":{"URL":"https:\/\/nata.kglmeridian.com\/view\/journals\/attr\/57\/4\/article-p325.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,6,15]]},"references-count":43,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2021,6,15]]},"published-print":{"date-parts":[[2022,4,1]]}},"URL":"https:\/\/doi.org\/10.4085\/1062-6050-0407.20","relation":{},"ISSN":["1938-162X","1062-6050"],"issn-type":[{"value":"1938-162X","type":"electronic"},{"value":"1062-6050","type":"print"}],"subject":[],"published":{"date-parts":[[2021,6,15]]}}}