Retro-step Test is a Sensitive Measure of Functional Deficits in Patients with ACL Reconstruction.

Abstract

Background: Functional deficits after ACL reconstruction are commonly based on the measurements of hop distance and knee laxity. It has been suggested that these tests are not sensitive enough to detect all deficits. PURPOSE: The purpose of this study was to explore if the retro step test was more sensitive than standard functional measurements in males and females with a history of ACL reconstruction. METHODS: A total of 62 participants (24 males, 38 females) who had a single surgical reconstruction (1/2 to 18 years post-surgery) were evaluated. Clinical and functional measurements were conducted as well as the IKDC (International Knee Documentation Committee) and KOOS (Knee and Osteoarthritis Outcome Score) questionnaires. Limb symmetry indices (LSI) were calculated ([(surgical/nonsurgical)* 100]) to express function of the surgical limb relative to the healthy limb. RESULTS: Overall, the single leg hop, the single leg crossover hop, and the retro step progressively demonstrated greater deficits with LSI's below 85% in 11%, 18%, and 30% of the population respectively. Females tended to have significantly more ligament laxity than the males (p = .051). However, the group means for men and women were both <3 mm of excursion. Females reported significantly less symptoms (p = .002) and better knee related quality of life (p = .034) scores compared to the males on the KOOS subjective questionnaire. CONCLUSIONS: The retro step test showed deficits in a greater portion of the population suggesting it is more sensitive in detecting functional deficits than the single leg hop and crossover triple hop tests in patients with ACL reconstruction. Although a slightly higher laxity was exhibited in women, they had equal success and higher subjective satisfaction after surgery.