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Criteria for Return to Sport after Anterior Cruciate Ligament reconstruction with lower reinjury risk (CR’STAL study): protocol for a prospective observational study in France
  1. Alexandre J M Rambaud1,2,
  2. Bertrand Semay1,3,
  3. Pierre Samozino4,
  4. Jean-Benoît Morin5,
  5. Rodolphe Testa1,
  6. Rémi Philippot1,3,
  7. Jérémy Rossi1,
  8. Pascal Edouard1,6
  1. 1 Inter‐university Laboratory of Human Movement Biology (LIBM EA 7424), University of Lyon, University Jean Monnet, Saint-Etienne, France
  2. 2 Physiotherapy Clinic of the Sport Center, La Talaudière, France
  3. 3 Department of Orthopaedic and Trauma Surgery, University Hospital Center of Saint-Etienne, Hôpital Nord, Saint-Etienne, France
  4. 4 Université Savoie Mont Blanc, Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM), EA 7424, F-73000 Chambéry, France
  5. 5 Université Côte d’Azur,LAMHESS, Nice, France
  6. 6 Department of Clinical and Exercise Physiology, Sports Medicine Unit, University Hospital of Saint-Etienne, Faculty of Medicine, Saint-Etienne, France
  1. Correspondence to Alexandre J M Rambaud; alexandre.rambaud.kine{at}


Introduction The decision regarding when to return to sport after an anterior cruciate ligament reconstruction (ACLR) is an important one. Using a variety of subjective and objective parameters, various attempts have been made to determine an optimal timeline for a return to sport after ACLR, but none have been validated.

The aim of the present study is therefore to determine which criteria or combination of criteria could allow to return to sport with the lowest possible risk of reinjury.

Methods and analysis This study is a prospective cohort, single-centre study, with repeated assessments at 6, 9 and 12 months post-ACL surgical reconstruction and including a 3-year follow-up of patients’ sporting activity and reinjuries. 275 patients will be included to test explanatory variables. Postural control analysis, knee laxity, questionnaires (International Knee Documentation Committee (IKDC), Tampa Scale of Kinesiophobia-11 (TSK-11), Anterior Cruciate Ligament—Return to Sport After Reinjury (ACL-RSI) and Single Assessment Numeric Evaluation (SANE)), modified Star Excursion Balance Test, running and sprinting biomechanics, Hop Tests and Isokinetic Tests will all be used. The primary outcome will be any reinjury during the follow-up period, defined as a graft rupture, a contralateral ACL rupture or any injury necessitating an interruption of training and requiring a medical consultation. Two groups will be constituted during the follow-up, separating reinjured from non-reinjured patients. In addition, classic analysis and data mining approaches will be used to build predictive models.

Ethics and dissemination The results of this study will be disseminated through peer-reviewed publications and scientific presentations. Ethical approval was obtained through the ethics committee of the University Hospital of Saint-Etienne (reference number IRBN522015/CHUSTE).

  • anterior cruciate ligament reconstruction
  • injury prevention
  • risk factors
  • return to sport
  • biomechanics

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  • Acknowledgements The authors are grateful to the study participants, hospital staff and study staff and, especially, Léa Feuillassier, Alex Pavoine, Antoine Dany and Stephane Moret.

  • Contributors AJMR, BS and PE designed the CR’STAL study and contributed to development of the study protocol. AJMR and BS drafted themanuscript. BS submitted to ethic committee. AJMR, BS, RT, PS, JBM, RP and PE assisted in drafting the manuscript. All authors read and approved the finalmanuscript.

  • Funding This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Ethics approval Ethical approval was obtained through the University Hospital of Saint-Etienne Ethics Committee (reference number IRBN522015/CHUSTE).

  • Provenance and peer review Not commissioned; externally peer reviewed.

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