Tehran University of Medical Sciences Journal of Orthopedic and Spine Trauma 2538-2330 12 2 2026 05 18 64 7 Ebrahim Piri PhD in Sports Biomechanics, Department of Sports Biomechanics, Faculty of Educational Sciences and Psychology, University of Mohaghegh Ardabili, Ardabil, Iran Amir Jafarnezhadgro Associate Professor, Department of Sports Biomechanics, Faculty of Educational Sciences and Psychology, University of Mohaghegh Ardabili, Ardabil, Iran 2025 08 22 2026 05 17 Securing a durable and effective reintegration into athletic activities after anterior cruciate ligament reconstruction (ACLR) viasurgery, constitutes an intricate and multifactorial endeavor. While most patients express strong optimism for unrestricted sports resumption, empirical outcomes reveal a notable disparity: only approximately 50% of individuals regain their prior competitive level, and among this group, one in five encounters a subsequent anterior cruciate ligament (ACL) rupture. In recent years, numerous assessment frameworks have been introduced to gauge postoperative readiness and mitigate the likelihood of recurrent injury. Nevertheless, contemporary studies indicate that a significant number of sports practitioners do not fulfill conventional clearance benchmarks, and notably, achieving these benchmarks does not invariably safeguard against a second injury, thereby calling into question their prognostic utility. This observed limitation implies that prevailing evaluation methods may possess inadequate discriminative capacity. The results derived from such assessments arguably mirror the caliber and comprehensiveness of the preceding rehabilitative intervention, thus inviting a rigorous reappraisal of standard therapeutic regimens. A pivotal inquiry emerges regarding the adequacy of contemporary preparation strategies in equipping athletes for the rigorous, dynamic, and stochastic challenges inherent in field and court sports. This integrative narrative analysis consolidates seminal findings from the last fifteen years, concentrating on three pivotal domains: 1) contemporary methodologies for evaluating return-to-sport readiness, 2) the architecture and efficacy of postoperative rehabilitation protocols, and 3) the conceptualization of the return-to sport process as a sequential continuum. These dimensions are examined through a unified and overarching analytical framework. https://jost.tums.ac.ir/index.php/jost/article/view/702 https://jost.tums.ac.ir/index.php/jost/article/download/702/464