Sugimoto Dai, Bizzini Mario, Callista Joan Putri, Daley Mary M, Kimura Yuka, Maly Tomas, Patacchiola Genna S, Paterno Mark V
Division of Sports Medicine, Boston Children's Hospital, Boston, MA, USA.
The Micheli Center for Sports Injury Prevention, Waltham, MA, USA.
Open Access J Sports Med. 2025 Aug 31;16:107-117. doi: 10.2147/OAJSM.S502778. eCollection 2025.
Although exercises and physical activities are beneficial for overall health, it can unfortunately result in a musculoskeletal injury that requires a surgical intervention in physically active youth. One of the major injures young athletes sustain is anterior cruciate ligament (ACL) tear, which often requires a surgical intervention. Following the ACL reconstruction (ACLR) surgery, athletes need to participate in rehabilitation and often perform return-to-sport (RTS) testing. During this process, the RTS decision requires the contributions of multidisciplinary sports medicine healthcare providers.
To discuss how to optimize a safe RTS from the perspective of multidisciplinary sports medicine healthcare practitioners and synthesize them with research-based evidence using a clinical scenario involving a female athlete following ACL injury.
A clinical scenario of a young female basketball player with an ACL tear is presented. In this particular case, the patient had a previous ACL tear history in her contralateral limb. Thigh circumference, knee range of motion, quadriceps and hamstrings strength, hop tests, and psychological readiness measures at 9 months post-operatively is also presented.
An orthopaedic surgeon, academic-physiotherapist, sports psychiatrist, clinical physical therapy, and performance and sport scientist provided their RTS perspectives based on the given scenario. Because of her previous history and low psychological readiness, several emerging concepts were discussed including neurocognitive-based rehabilitation, cognitive-behavioral therapy, and step-by-step RTS progression (return to participation, sport, and performance).
The current article synthesized clinical insights from various sports medicine healthcare with practitioners and research evidence based on an ACL clinical scenario. The approaches discussed in this paper may be beneficial to facilitate safe RTS.
尽管运动和体育活动对整体健康有益,但不幸的是,在积极参加体育活动的青少年中,这可能会导致肌肉骨骼损伤,需要进行手术干预。年轻运动员遭受的主要损伤之一是前交叉韧带(ACL)撕裂,这通常需要手术干预。在ACL重建(ACLR)手术后,运动员需要参与康复训练,并经常进行重返运动(RTS)测试。在此过程中,RTS决策需要多学科运动医学医疗服务提供者的共同参与。
从多学科运动医学医疗从业者的角度讨论如何优化安全的RTS,并结合基于研究的证据,以一名ACL损伤的女性运动员为例进行临床分析。
介绍一名年轻女性篮球运动员ACL撕裂的临床病例。在这个具体病例中,患者对侧肢体曾有过ACL撕裂史。还展示了术后9个月时的大腿围度、膝关节活动范围、股四头肌和腘绳肌力量、单腿跳测试以及心理准备情况测量结果。
一名骨科医生、学术物理治疗师、运动精神科医生、临床物理治疗师以及运动表现和运动科学家根据给定病例提供了他们对RTS的看法。由于她之前的病史和较低的心理准备状态,讨论了几个新出现的概念,包括基于神经认知的康复、认知行为疗法以及逐步的RTS进展(恢复参与、运动和表现)。
本文结合了来自不同运动医学医疗从业者的临床见解以及基于ACL临床病例的研究证据。本文讨论的方法可能有助于促进安全的RTS。