Approximately 62% of high-activity athletes (preinjury Tegner Activity Scale ≥7) return to similar strenuous sports within 12 months after primary ACL reconstruction.
Female sex, older age, lower sporting level, and delayed surgery predict reduced likelihood of return to high-level activity.
Psychological readiness measured by the ACL-Return to Sport after Injury (ACL-RSI) score at 3 months post-operation is a strong, potentially modifiable predictor of return to sport.
Secondary ACL injury rates do not differ by sex or return-to-sport status, with an overall 9.2% incidence within 24 months.
