Assimetria de força de membros inferiores na reabilitação pós-cirurgia de LCA no retorno ao esporte

Anterior cruciate ligament (ACL) reconstruction is a common procedure in athletes, but the return to sport does not always occur as expected, and reinjuries remain frequent. This narrative literature review discusses how lower limb strength asymmetry relates to clearance criteria for returning to sport and the occurrence of new injuries following ACL reconstruction. The instruments used to assess asymmetry were described, the validity of the Limb Symmetry Index (LSI) as an isolated criterion was discussed, and the relationship between residual strength deficits and injury recurrence was analyzed. The reviewed literature indicates that restoring quadriceps strength is a central component of rehabilitation, but the LSI alone may overestimate knee function, as the uninvolved limb also experiences strength loss. Delaying the return and meeting objective discharge criteria were associated with a lower risk of reinjury. It is concluded that clearance must integrate muscle strength, functional criteria, and the time elapsed since surgery, focusing especially on young athletes and pivoting sports.