Single-Leg Hop Performance After Anterior Cruciate Ligament Reconstruction: Ready for Landing but Cleared for Take-Off?

Abstract

Context: Although the landing phases of the single-leg hop for distance (SLHD) are commonly assessed, limited work reflects how the take-off phase influences hop performance in patients with anterior cruciate ligament reconstruction (ACLR).

Objective: To compare trunk and lower extremity biomechanics between individuals with ACLR and matched uninjured controls during take-off of the SLHD.

Design: Cross-sectional study design.

Setting: Laboratory setting.

Patients or other participants: Sixteen individuals with ACLR and 18 uninjured controls.

Main outcome measure(s): Normalized quadriceps isokinetic torque, hop distance, and respective limb symmetry indices were collected for each participant. Sagittal and frontal kinematics and kinetics of the trunk, hip, knee, and ankle as well as vertical and horizontal ground reaction forces were recorded for loading and propulsion of the take-off phase of the SLHD.

Results: Those with ACLR had weaker quadriceps peak torque in the involved limb (P = .001) and greater strength asymmetry (P < .001) than control individuals. Normalized hop distance was not statistically different between limbs or between groups (P > .05), and hop distance symmetry was not different between groups (P > .05). During loading, the involved limb demonstrated lesser knee flexion angles (P = .030) and knee power (P = .007) than the uninvolved limb and lesser knee extension moments than the uninvolved limb (P = .001) and controls (P = .005). During propulsion, the involved limb demonstrated lesser knee extension moment (P = .027), knee power (P = .010), knee (P = .032) and ankle work (P = .032), and anterior-posterior ground reaction forces (P = .047) and greater knee (P = .016) abduction excursions than the uninvolved limb.

Conclusions: Between-limb differences in SLHD take-off suggest a knee underloading strategy in the involved limb. These results provide further evidence that distance covered during SLHD assessment can overestimate function and fail to identify compensatory biomechanical strategies.