Clinician Perspectives on Biomechanical Analysis and Return to Play: Pediatric Versus Adult

Despite prevention, surgical, and rehabilitation advances, up to 250,000, Anterior Cruciate Ligament (ACL) injuries occur annually in the United States, with 25–32% suffering a secondary ACL injury. Musculoskeletal strength, functional performance, neuromuscular control, biomechanical performance, and psychological readiness contribute to successful outcomes post-ACL reconstruction (ACLR). Altered biomechanics related to injury mechanism exist post-ACLR and may persist after return to play (RTP) increasing secondary injury risk. Biomechanical analysis is a useful quantitative tool to complement current clinical care decisions. However, there is limited usage of biomechanical analysis due to technological access, financial costs, and limited understanding. The purpose of this chapter is to describe the clinical utility of biomechanical analysis in post-ACLR rehabilitation and RTP clearance. Detailed information regarding specific biomechanical tests and tools is covered, with the goal of making biomechanical testing quick, easy, and affordable. An additional purpose of this chapter is to analyze the current evidence regarding RTP decision-making, and outcomes based on age and sex.