Change of direction assessment following anterior cruciate ligament reconstruction: a review of current practice and considerations to enhance practical application

Review written by Dr Carlo Wood info

Key Points

  1. Current field-based testing does not recreate relevant sport demands and is not capable of entirely assessing knee motor strategies and biomechanics following ACL reconstruction. Laboratory-based studies are able to uncover residual deficits and altered movement strategies at the time of return to sport which can be related to increased risk of re-injury.
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BACKGROUND & OBJECTIVE

35% percent of athletes who have undergone an ACLR don’t return to their pre-injury level within 2 years, and 20% of those that return to sport (RTS) in the first year suffer a second rupture.

Change of direction (CoD) is a mechanism of non-contact ACL injury. There is a lack of research on CoD in RTS testing, and the ability to identify associations with return to pre-injury levels or secondary injuries.

The aim of this article was to describe the movement strategies exhibited following ACLR during CoD and analyze the ability of commonly used tests to identify reductions in pre-injury performance and/or athletes at higher risk of secondary injury.

35% percent of athletes who have undergone an ACLR don’t return to their pre-injury level within 2 years.
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Lack of exposure to these movements leaves the athlete underprepared for the demands of the game, leading to an increased risk of re-injury.

METHODS

The authors performed searches of MEDLINE, PubMed and SPORT Discuss electronic databases for studies pertaining to CoD assessments following ACLR published between 1970 and April 2019. The search strategy combined ‘change of direction’ and ‘anterior cruciate ligament reconstruction’. The reference

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