Evidence map›Paper›PMID 40894294›Full record

ReviewJournal of clinical orthopaedics and trauma2025

Optimizing return to sports after anterior cruciate ligament reconstruction: A multi-factorial umbrella review on rehabilitation strategies.

Ravinder Kumar, Vikram Singh, T Onima Reddy

Abstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in Journal of clinical orthopaedics and trauma, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Review
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors.

Ravinder KumarBanaras Hindu University, Varanasi, 221005, India.
Vikram SinghDepartment of Physical Education, Banaras Hindu University, Varanasi, 221005, India.
T Onima ReddyDepartment of Physical Education, Banaras Hindu University, Varanasi, 221005, India.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Anterior cruciate ligament reconstruction (ACLR) is a widely performed orthopedic procedure aimed at restoring knee function. However, return-to-sport (RTS) outcomes remain inconsistent due to variability in rehabilitation strategies, psychological readiness, and the integration of emerging technologies. Objective: This umbrella review synthesizes high-level evidence on rehabilitation strategies influencing successful RTS post-ACLR, including functional assessments, strength recovery, psychological readiness, blood flow restriction (BFR) training, and wearable technologies. Methods: A systematic umbrella review of 55 studies (2019-2024) was conducted following PRISMA guidelines and registered in PROSPERO (CRD42025646262). Literature searches were performed across PubMed, Scopus, and Web of Science. Reviews were included based on the PICOS framework and assessed using the Modified Newcastle-Ottawa Scale and the GRADE approach. Results: RTS outcomes were more favorable when guided by objective, criteria-based protocols rather than time-based approaches. Functional tests such as the single-leg hop and limb symmetry index (LSI ≥90-95 %) reliably predicted readiness. BFR training initiated early postoperatively yielded moderate-to-large effects on hypertrophy (SMD: 0.37-0.82) and strength (SMD: 0.47-0.79, p < 0.01). Psychological readiness, particularly ACL-RSI scores ≥70, significantly correlated with successful RTS (OR: 2.1-2.5, p < 0.001). Wearable sensors and machine learning models showed promise for recovery monitoring and reinjury prediction, though heterogeneity limited synthesis. Conclusion: Multifactorial, criterion-based rehabilitation approaches integrating physical performance, psychological readiness, and emerging technologies enhance RTS outcomes post-ACLR. Future research should prioritize standardized protocols, long-term outcome tracking, and inclusion of underrepresented populations.

Indexed as

Anterior cruciate ligament reconstructionMachine learningPhysical therapy modalitiesPsychological readinessRehabilitationReturn to sportStrength trainingWearable sensors

Identifiers

PMID40894294
PMCPMC12397920

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.