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Sports activity level after ACL reconstruction is predicted by vastus medialis or vastus medialis obliquus thickness, single leg triple hop distance or 6-m timed hop, and quality of life score

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Abstract

Purpose

Recovery after anterior cruciate ligament reconstruction (ACLR) may take > 2 years, and younger athletes have higher re-injury risk. The purpose of this prospective longitudinal study was to determine how the early to mid-term Tegner Activity Level Scale (TALS) scores of athletically active males ≥ 2 years post-ACLR follow-up was predicted by bilateral isokinetic knee extensor and flexor torque, quadriceps femoris thickness, single leg hop test performance, and self-reported knee function (Knee Injury and Osteoarthritis Outcome Score (KOOS); International Knee Documentation Committee (IKDC) Subjective Assessment score).

Methods

After ACLR with a hamstring tendon autograft and safely returning to sports at least twice weekly, 23 men (18.4 ± 3.5 years of age) were evaluated at final follow-up (mean = 4.5, range = 2–7 years). Exploratory forward stepwise multiple regression was used to determine the relationship between independent surgical and non-surgical lower limb variables peak concentric isokinetic knee extensor-flexor torque at 60°/sec and 180°/sec, quadriceps femoris muscle thickness, single leg hop test profile results, KOOS subscale scores, IKDC Subjective Assessment scores, and time post-ACLR on TALS scores at final follow-up.

Results

Subject TALS scores were predicted by KOOS quality of life subscale score, surgical limb vastus medialis obliquus (VMO) thickness, and surgical limb single leg triple hop for distance (SLTHD) performance. Subject TALS scores were also predicted by KOOS quality of life subscale score, non-surgical limb vastus medialis (VM) thickness, and non-surgical limb 6 m single leg timed hop (6MSLTH) performance.

Conclusion

TALS scores were influenced differently by surgical and non-surgical lower extremity factors. At ≥ 2 years post-ACLR, ultrasound VM and VMO thickness measurements, single leg hop tests that challenge knee extensor function, and self-reported quality of life measurements predicted sports activity levels. The SLTHD test may be better than the 6MSLTH for predicting long-term surgical limb function.

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Authors and Affiliations

  1. Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey

    Gulcan Harput & Volga Bayrakci Tunay

  2. Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Balıkesir University, Balıkesir, Turkey

    Serdar Demirci

  3. Kosair Charities College of Health and Natural Sciences, Athletic Training Program, Norton Orthopedic Institute, Spalding University, 901 South 4Th Street, Louisville, KY, USA

    John Nyland

  4. Department of Biophysics, Faculty of Medicine, Hacettepe University, Ankara, Turkey

    Abdullah Ruhi Soylu

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Harput, G., Demirci, S., Nyland, J. et al. Sports activity level after ACL reconstruction is predicted by vastus medialis or vastus medialis obliquus thickness, single leg triple hop distance or 6-m timed hop, and quality of life score. Eur J Orthop Surg Traumatol 33, 3483–3493 (2023). https://doi.org/10.1007/s00590-023-03571-5

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