Screening Tests for Assessing Athletes at Risk of ACL Injury or Reinjury—A Scoping Review

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.

Reinjury Following Return to Play

“…However, the authors conclude that despite this controversy, some physiologic tests can provide clinically relevant information that would allow clinicians to track progress during athletic training and determine RTP while offering tailored preventive countermeasures. 52 Standardization of rehabilitation programs and consensus on how to prepare patients for successful RTP is lacking; however, current evidence points toward the benefits of individualized RTP processes. 53 According to a recent consensus statement, the RTP decision is multifactorial and should consider not only time from injury but also treatment, clinical exam, RTP testing, assessment of psychological readiness, and sport-specific conditions.…”

“…However, the authors conclude that despite this controversy, some physiologic tests can provide clinically relevant information that would allow clinicians to track progress during athletic training and determine RTP while offering tailored preventive countermeasures. 52…”

External mechanical perturbations challenge postural stability in dogs

“…A typical parameter used to evaluate PS in human patients is the center of pressure (COP) (3)(4)(5)(6)(7)(8)(9), which has recently been used in veterinary medicine . The COP is the location of the instantaneous vector of ground reaction forces and displays the trajectory of the center of mass of the body.…”

Investigating the Role of Proximal Femoral Morphology in Non-Contact ACL Injuries: A Comparative Study

“…Different studies indicate that certain individuals are more susceptible to experiencing an ACL rupture [4], [5]. Moreover, those who have previously sustained such an injury still have a high risk for re-rupture.…”