Poor functional performance 1 year after ACL reconstruction increases the risk of early osteoarthritis progression

Review written by Dr Christina Le info

Key Points

  1. Only 1 in 5 participants in this study achieved the 90% limb symmetry index cut-off on all four functional performance tests at 1-year post-ACL reconstruction (ACLR).
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The harsh reality for individuals who sustain an anterior cruciate ligament (ACL) rupture is that their risk of developing knee osteoarthritis (OA) increases substantially (1). Although quadriceps weakness is a risk factor for developing OA, the relationship between other functional performance tasks and early onset of OA is unknown (2).

The primary objective of this study was to determine if functional performance 1 year following ACL reconstruction (ACLR) was associated with 1) the risk of patellofemoral and/or tibiofemoral OA on MRI, and 2) changes in patient-reported outcomes between 1 and 5 years.

The risk of developing knee osteoarthritis increases substantially after ACL rupture.
Improving functional deficits during rehabilitation may benefit both return to sport aspirations and simultaneously delay or prevent the development of osteoarthritis.


Individuals who underwent a single-bundle hamstring autograft ACLR were assessed 1 and 5 years after surgery. Participants completed a battery of functional tests including single-leg hop (cm), crossover hop (cm), single-leg side hop (max reps in 30 seconds), and one-leg

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