The Role Of Strength And Sensation In Return-to-sport Readiness After Anterior Cruciate Ligament Reconstruction

PURPOSE: Anterior cruciate ligament reconstruction (ACLR) is the most common surgery for anterior cruciate ligament (ACL) injuries. The correlations of strength, proprioception, and tactile sensation with patients’ return to sports (RTS) readiness remain unclear among patients with ACLR. This study aimed to investigate these correlations in patients with ACLR. METHODS: A total of 42 participants were enrolled (female = 12, 27.6 ± 6.8 years, 181.8 ± 9.0 cm, 80.4 ± 8.9 kg, postoperative duration: 10.3 ± 3.8 months). Muscle strength of knee flexion and extension, proprioception of knee flexion and extension, and tactile sensation at the great toe, 1st and 5th metatarsals, arch, and heel were tested. RTS readiness was recorded using the Knee Santy Athletic Return to Sports (K-STARTS) test, which consists of a psychological scale [Anterior Cruciate Ligament Return to Sports after Injury scale (ACL-RSI)] and seven functional tests. Partial correlations were used to determine relationships among variables, while factor analysis and multivariable linear regressions were employed to determine the degrees of correlation. RESULTS: Knee flexion (r = .340, p = .032) and extension (r = .415, p = .008) strength, knee flexion (r = -.316, p = .047) and extension (r = -.321, p = .044) proprioception, and the tactile sensation at the fifth metatarsal (r = -.395, p = .012) were correlated with K-STARTS total. Knee extension strength (r = .358, p = .023) was correlated with ACL-RSI. Knee flexion (r = .374, p = .017) and extension (r = .327, p = .040) strength, knee flexion (r = -.355, p = .025) and extension (r = -.340, p = .032) proprioception, and tactile sensation at the fifth metatarsal (r = -.426, p = .006) were correlated with functional scores. Strength contributed to K-STARTS total (βF1 = 0.483 > βF2 = 0.268) and functional scores (βF1 = 0.439 > βF2 = 0.332) more compared to proprioception. CONCLUSIONS: Rehabilitation for ACLR patients should prioritize muscle strength, followed by proprioception, with tactile sensation as a lesser focus.