Return to Play/Sport
Dr. Logan's Top 10 factors to assess on Return to Play testing following Complex Knee Surgery
- Timing: Risk of early re-rupture is high in younger patients; I do not recommend RTS prior to 9 mos for most complex knee surgery.
- RTS clearance is a multi-disciplinary decision: surgeon, physical therapist, athletic trainer, and may include mental health professionals.
- RTS clearance is a mix of physical exam, RTS testing and psychological readiness.
- Physical Exam: no pain, no effusion, full ROM, stable ligamentous test, thigh girth > 90% of the contralateral side. Bonus points for good ankle mobility.
- Balance/Neuromuscular Control - my favorite tests: >90% contralateral side
- Movement Quality: assess for dynamic valgus with single leg squats, drop jumps and countermovement jumps. Be sure to assess with multiple reps (effect of fatigue.
- Observational, qualitative drop jump testing: (LESS/Landing Error Scoring System) - assess with fatigue
- Agility - need a guide on the go, here is the Vail Sports Test: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3290923/#app
- Mental Health - Assess with ACLR-RSI- never be afraid to encourage your athlete to seek help if you are concerned.
- Finally, data is important. Not only does it help you make decisions about RTP, but it promotes buy-in from the patient to keep up with their programming!