Is there a way to Predict if you will need ACL Surgery?

ACL surgery can be tough, often involving time on crutches and extensive rehab. Recent research has begun to question if some patients are better off without knee ACL surgery. In addition, we’ve used various stem cell treatments to help patients avoid ACL surgery. So if you’ve recently injured your ACL, is there a way to predict if you’ll do well without surgery? Can a simple test predict if you’ll be able to avoid ACL surgery? A recent study investigated whether a single legged hop test for distance could tell who would do well 1 year after their ACL injury. The study tested 91 patients who were about 2 months out from an ACL injury, but who didn’t opt for ACL reconstruction surgery. 89% of these same patients were then retested about a year later. It turns out that the single hop test for distance predicted those patients who were more functional at a year out. In addition, more women had difficulty at that point then did men. How do you perform this test? Stand on one leg, with your foot on a starting line (some fixed point you can measure from), and perform a maximal hop forward, landing on the same leg (along a straight line).  Arms may swing freely to assist, be held on hips, or behind the back.  The distance is measured from the starting line to where the back of the heel lands.  Landing position must be held for 2 seconds with no loss of balance or extra steps. The hop is scored by comparing the bad leg to the good leg. For example, if you could hop 3 feet on the bad leg and 6 feet on the good leg, then you would divide 3 by 6 to get 0.50 and multiply by 100 to get a percentage of the good leg hop. Here that would be 50%. In this study, the cut off for someone doing well a year out from their injury was an 88% hop on the bad leg (as compared to the good leg hop) when measured at about 2 months after injury. The upshot? If you’ve recently injured your ACL, you may want to use this simple test to see if you can avoid ACL surgery.