Evidence-based return-to-sports testing after joint surgery. An overview of scientifically validated movement screening methods

The resumption of sporting activities following surgical intervention of joints is still a critical point in the rehabilitation process of an athlete and is often associated with an increased risk of re-injury. Musculoskeletal screening tests may allow identifying of already preoperatively or postoperatively existing specific functional deficits and adapting the rehabilitation training of the athlete. Although marker-based three-dimensional motion analyses are still considered the gold standard of musculoskeletal function analysis, it is commonly too complex and expensive for usage in daily clinical routine. Therefore, a large variety of simple functional screening tools were mainly developed und evaluated in North America in recent decades, yielding acceptable levels in reliability as well as sufficient values of sensitivity and specificity. In order to further increase their diagnostic value, they are often combined with so-called test batteries. But if an overall score is created by combining various tests, it should be guaranteed that no single (sub) test with inferior sensitivity is included. In order to achieve a high diagnostic value, the test parameters may include dynamic strength, fatigue testing, and neuromuscular coordination. The test battery should be conducted by specifically qualified personnel and the athlete should only perform tasks that he or she is able to realize without any additional injury risk. Overall, this review gives an overview of some appropriate clinical screening tests that have been scientifically validated and which can be used in a daily clinical setting.