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Menzer H, Slater LV, Diduch D, et al. The Utility of Objective Strength and Functional Performance to Predict Subjective Outcomes After Anterior Cruciate Ligament Reconstruction. Orthop J Sports Med. 2017;5(12):2325967117744758doi: 10.1177/2325967117744758.
Menzer, H., Slater, L. V., Diduch, D., Miller, M., Norte, G., Goetschius, J., & Hart, J. M. (2017). The Utility of Objective Strength and Functional Performance to Predict Subjective Outcomes After Anterior Cruciate Ligament Reconstruction. Orthopaedic journal of sports medicine, 5(12), 2325967117744758. https://doi.org/10.1177/2325967117744758
Menzer, Heather, et al. "The Utility of Objective Strength and Functional Performance to Predict Subjective Outcomes After Anterior Cruciate Ligament Reconstruction." Orthopaedic journal of sports medicine vol. 5,12 (2017): 2325967117744758. doi: https://doi.org/10.1177/2325967117744758
Menzer H, Slater LV, Diduch D, Miller M, Norte G, Goetschius J, Hart JM. The Utility of Objective Strength and Functional Performance to Predict Subjective Outcomes After Anterior Cruciate Ligament Reconstruction. Orthop J Sports Med. 2017 Dec 18;5(12):2325967117744758. doi: 10.1177/2325967117744758. eCollection 2017 Dec. PMID: 29318168; PMCID: PMC5753987.
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Orthop J Sports Med. 2017 Dec 18;5(12):2325967117744758. doi: 10.1177/2325967117744758. eCollection 2017 Dec.

The Utility of Objective Strength and Functional Performance to Predict Subjective Outcomes After Anterior Cruciate Ligament Reconstruction.

Orthopaedic journal of sports medicine

Heather Menzer, Lindsay V Slater, David Diduch, Mark Miller, Grant Norte, John Goetschius, Joseph M Hart

Affiliations

  1. Department of Orthopaedic Surgery, University of Virginia, Charlottesville, Virginia, USA.
  2. Shirley Ryan AbilityLab, Neuromechanics of Impaired Locomotion Lab, Chicago, Illinois, USA.
  3. School of Exercise and Rehabilitation Sciences, University of Toledo, Toledo, Ohio, USA.
  4. Department of Exercise Science and Athletic Training, Adrian College, Adrian, Michigan, USA.

PMID: 29318168 PMCID: PMC5753987 DOI: 10.1177/2325967117744758

Abstract

BACKGROUND: Many clinicians release patients to return to activity after anterior cruciate ligament reconstruction (ACLR) based on time from surgery despite deficits in muscle strength and function. It is unclear whether symmetry or unilateral performance is the best predictor of subjective outcomes after ACLR.

PURPOSE: To determine physical performance predictors of patient-reported outcomes after reconstruction.

STUDY DESIGN: Cross-sectional study; Level of evidence, 3.

METHODS: A total of 88 participants (49 males, 39 females; mean ± SD height, 174.0 ± 9.6 cm; weight, 76.1 ± 18.5 kg; age, 19.4 ± 3.7 years) who underwent primary, unilateral ACLR volunteered for this study. Participants had undergone reconstruction a mean of 6.9 ± 1.8 months (range, 5.0-14.1 months) before the study. All participants underwent strength testing as well as hop testing and then completed the International Knee Documentation Committee (IKDC) and Knee injury and Osteoarthritis Outcome Score (KOOS) questionnaires. Stepwise linear regression models were used for symmetry and unilateral performance to identify the proportion of variance explained in the IKDC score, KOOS total score, KOOS-sport subscale, and time from surgery, as well as receiver operating characteristic (ROC) curve analyses on those variables that explained the most variance in patient-reported outcomes to determine cutoff thresholds.

RESULTS: No significant correlations were found between time from surgery and objective performance. The only significant predictors of IKDC score were single-hop limb symmetry index (LSI) and age (

CONCLUSION: Hopping performance is the most predictive functional variable of subjective outcomes after reconstruction. Single-hop symmetry was most important for younger patients and unilateral triple-hop distance was most important for older patients. Clinicians should consider hopping performance when making return-to-activity decisions after ACLR.

Keywords: knee injury; rehabilitation; return to play

Conflict of interest statement

The authors declared that they have no conflicts of interest in the authorship and publication of this contribution.

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