Knee Surgery, Sports Traumatology, Arthroscopy

, 19:1798

Muscle strength and hop performance criteria prior to return to sports after ACL reconstruction


    • Department of Orthopaedics, Lundberg Laboratory for Orthopaedic ResearchSahlgrenska University Hospital
  • Yonatan Kaplan
    • Physical Therapy and Sports Medicine Institute Lerner Sports CenterHebrew University of Jerusalem
  • Joanna Kvist
    • Division of Physiotherapy, Department of Health and Society, Faculty of Health SciencesLinköping University
  • Grethe Myklebust
    • Oslo Sport Trauma Research Center, Norwegian School of Sports Sciences
  • May Arna Risberg
    • Department of Orthopaedic, Norwegian School of Sport Sciences, Hjelp24NIMIOslo University Hospital
  • Daniel Theisen
    • Sports Medicine Research Laboratory, Public Research Centre for Health
  • Elias Tsepis
    • Department of Physical Therapy, Technological Educational Institute of Patras (Aigio Branch)
  • Suzanne Werner
    • Department of Molecular Medicine and Surgery, Stockholm Sports Trauma Research CenterKarolinska Institute
  • Barbara Wondrasch
    • Vienna Sports Medicine Center
  • Erik Witvrouw
    • Department of Rehabilitation Sciences and Physical TherapyGhent University

DOI: 10.1007/s00167-011-1669-8

Cite this article as:
Thomeé, R., Kaplan, Y., Kvist, J. et al. Knee Surg Sports Traumatol Arthrosc (2011) 19: 1798. doi:10.1007/s00167-011-1669-8



The purpose of this article is to present recommendations for new muscle strength and hop performance criteria prior to a return to sports after anterior cruciate ligament (ACL) reconstruction.


A search was made of relevant literature relating to muscle function, self-reported questionnaires on symptoms, function and knee-related quality of life, as well as the rate of re-injury, the rate of return to sports and the development of osteoarthritis after ACL reconstruction. The literature was reviewed and discussed by the European Board of Sports Rehabilitation in order to reach consensus on criteria for muscle strength and hop performance prior to a return to sports.


The majority of athletes that sustain an (ACL) injury do not successfully return to their pre-injury sport, even though most athletes achieve what is considered to be acceptable muscle function. On self-reported questionnaires, the athletes report high ratings for fear of re-injury, low ratings for their knee function during sports and low ratings for their knee-related quality of life.


The conclusion is that the muscle function tests that are commonly used are not demanding enough or not sensitive enough to identify differences between injured and non-injured sides. Recommendations for new criteria are given for the sports medicine community to consider, before allowing an athlete to return to sports after an ACL reconstruction.

Level of evidence



Return to sportStrengthHop performancePatient’s opinionKnee function

Copyright information

© Springer-Verlag 2011