The Impact of Functional Outcomes Following Anterior Cruciate Ligament Reconstruction on Return to Sport in Basketball Players: A Systematic Review

Abstract

Anterior cruciate ligament (ACL) injuries are common among basketball players and have a significant impact on athletic performance; consequently, the extent to which athletes can return to competitive level following reconstruction surgery has become a key focus of sports rehabilitation research. Basketball involves frequent jumping, rapid changes of direction and physical contact, placing high demands on lower limb strength and dynamic stability. The degree of functional recovery following surgery directly influences an athlete’s ability to participate in training and competition, and is closely linked to the risk of re-injury. Previous studies have shown that determining the timing of return to sport based solely on postoperative time does not accurately reflect actual functional status. Functional performance has gradually become the core basis for assessment, primarily encompassing muscle strength, jumping ability, dynamic balance, neuromuscular control and sport-specific performance, whilst also involving functional symmetry and subjective perceptions of recovery. These indicators influence one another and collectively determine athletic performance. Current evidence suggests that multidimensional functional assessments hold greater value than single-parameter measures, and sport-specific functional testing is increasingly being prioritised. However, issues such as discrepancies in assessment criteria and a lack of sport-specific tests persist in the research literature. The development of a comprehensive assessment system that integrates basic functional abilities with sport-specific skills will help enhance the safety and effectiveness of postoperative return to sport for basketball players.