Consensus framing. The 2016 Bern consensus statement on return to sport (Ardern et al., Br J Sports Med 2016;50:853–64) — an expert consensus, not a trial — describes return to sport as a continuum (return to participation → return to sport → return to performance) and recommends shared, criteria-informed decision-making rather than a date on a calendar. That's the framework used here.
Cohort evidence (ACL-specific). In the Delaware-Oslo ACL cohort (Grindem et al., Br J Sports Med 2016), 106 patients in pivoting sports were followed for two years after ACL reconstruction. Returning to level I sport carried a 4.3× higher reinjury rate; each month return was delayed (up to 9 months post-surgery) was associated with a 51% lower reinjury rate; and 38.2% of those who failed functional criteria were reinjured versus 5.6% of those who passed — though that last comparison did not reach statistical significance (p=0.075). This is an observational cohort in one injury population: it supports the value of measured function and patience, not a guarantee, and its numbers are not a promise about your knee — or any other joint.
Plainly: there is no universal passing score, testing is not medical clearance, and no test battery reduces reinjury risk to zero. What testing offers is honest information where guesswork usually lives.
