Abstract
Various tests are available to assess athletes for factors associated with their susceptibility and risk of anterior cruciate ligament (ACL) injury or reinjury; however, it is unclear which tests are clinically meaningful and what should be considered when using them. Therefore, the aim of this scoping review was to screen and summarize testing and to derive evidence-based recommendations for clinicians, practitioners and future research. Five databases were searched to identify studies addressing musculoskeletal morphology or functional-performance-related screening tests with a clear conceptual link or an evidence-based relationship to ACL (re)injury. A quality rating was carried out using the National Institutes of Health (NIH) Study-Quality Assessment Tool. Six different categories of common screening tests were identified: balance and postural control, gait- and running-related tests, joint laxity, joint morphology and anthropometrics, jump tests and strength tests. Predicting future injury in a complex, dynamic system based on a single screening test is methodologically challenging, which is also reflected in the highly controversial findings in the literature regarding potential associations between specific screening tests and the occurrence of ACL injuries and reinjuries. Nonetheless, various screening tests can provide clinically relevant information on ACL-(re)injury-related factors and help to provide tailored preventive measures. A selection of corresponding evidence-based recommendations is derived and presented in this scoping review.
Highlights
The social and economic burden of anterior cruciate ligament (ACL) injuries is substantial
CoM was 38 cm more posterior in the ACL injured athletes) [56]; (3) hip–ankle coordination during single-leg stance (M was calculated as a measure of the standard deviation of the ankle and hip angular position in the sagittal plane; M 166.2 (18.9) in controls and M 108.4 (10.1) in cases) [50]; (4) pelvic hike measured during a knee lift test (HR for high vs. low group 9.10; 95% CI 1.10–75.2) [42]; (5) lateral trunk displacement after trunk perturbation in single leg stance [61]; and (6) trunk position sense after automated structured trunk rotation in females [62]
The following metrics did not show any association with ACLinjury: (1) CoP path length and area, which encloses the CoP movement during the double-leg stance [15,19]; (2) CoP velocity during the single-leg stance with and without movement of the contralateral limb [59]; (3) trunk position sense after automated structured trunk rotation [62]; (4) reach distance in the Star Excursion Test [59]; and (5) anterior pelvic tilt, posterior pelvic tilt, pelvic hike and pelvic drop during a knee lift test [42]
Summary
The social and economic burden of anterior cruciate ligament (ACL) injuries is substantial. Lifetime costs are reported at nearly $40,000 for reconstructive surgery and almost. The incidence rate for ACL injuries in the general population has been reported to be 68.6 per 100,000 person-years, with particular susceptibility in male athletes in their early twenties and females in late adolescence [4]; the latter are three times more likely to suffer an ACL injury than males [5]. Anatomical, neuromuscular and proprioceptive aspects may contribute to this sex difference [6]. There is an increased risk of developing joint degeneration, such as osteoarthritis, later in life after ACL injury [7].
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