Functional Recovery After Anterior Cruciate Ligament Reconstruction: A Longitudinal Perspective

Abstract 

Hopper DM, Strauss GR, Boyle JJ, Bell J. Functional recovery after anterior cruciate ligament reconstruction: a longitudinal perspective.

Objective

To evaluate functional hop performance in subjects with an anterior cruciate ligament (ACL) reconstruction with a bone-patellar tendon-bone graft during 12, 18, 26, 39, and 52 weeks.

Design

A longitudinal comparative study.

Setting

University research laboratory.

Participants

Patients (N=19) were evaluated at 12, 18, 26, 39, and 52 weeks after ACL reconstruction surgery.

Intervention

Testing on 5 separate occasions.

Main Outcome Measures

The Cincinnati Knee Rating System and analog scales, the 6-meter timed hop, crossover hop, stair hop, and vertical hop, and limb symmetry indices.

Results

The uninjured and injured legs and test order were randomized. There was a significant test occasion main effect for both the Cincinnati and analog scores (P=.001). Subjective rating scores improved over the 5 testing occasions. For all 4 hop tests, test occasion and limb main effects were significant (P=.001). Paired t test comparisons at each testing occasion indicated a significant difference between the reconstructed and uninjured limb (P<.05). Furthermore, significant test occasion main effects were noted for limb symmetry indices for the 4 hop tests (P=.001). Using a score of greater than or equal to 85% as a criterion for normative limb symmetry, normative scores were recorded in the 6-m timed hop at the week 18 test occasion, the stair hop and vertical hop at the week 26 test occasion, and the crossover hop at the week 39 test occasion.

Conclusions

These hop tests showed different levels of imposed demands on the knee that could be used to assess functional recovery and readiness to resume sport.

Key Words: Anterior cruciate ligament, Knee, Rehabilitation

List of Abbreviations: ACL, anterior cruciate ligament, ANOVA, analysis of variance