Utilizing Hip Abduction Strength to Body-Weight Ratios in Return to Sport Decision-Making After ACL Reconstruction.
Steven Higbie, Jacquelyn Kleihege, Brian Duncan and 2 others
PMID 34631250WHAT IT FOUND
Athletes with hip abduction strength below 33% of body weight reported lower confidence and function at return-to-sport and two years later.
However, they had no more re-injuries than stronger athletes. Low strength flags reduced self-reported function, not necessarily physical risk.
Key findings
01Patients with low hip abduction strength to body weight ratios (<33%) reported significantly lower subjective function and psychological readiness at the time of release to activity compared to those with high strength.
02At two-year follow-up, the low strength group continued to report significantly lower knee function scores, but there was no significant difference in re-injury rates or current level of sports participation between the groups.
03No significant differences were found between the low and high strength groups on objective physical measures such as range of motion, Y-balance, or single-leg hop tests at the time of release.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
The study was retrospective, so groups were not randomly assigned, and baseline differences (age, weight, BMI) were significant and may have influenced the subjective outcomes. The 33% body weight cutoff was chosen for clinical practicality rather than being derived from this specific dataset's optimal threshold. The study did not control for concomitant procedures like cartilage repairs or multi-ligament reconstructions, which could affect outcomes. While statistically significant, the differences in subjective scores did not exceed the minimal clinically important difference for the IKDC or SANE scores, meaning the practical impact on patient experience may be small.
Declared interests
One author, Dr. Walter Lowe, is a medical consultant for Don Joy Inc. and Arthrex Inc., companies that manufacture orthopedic devices and rehabilitation equipment.
The easy way to misread this
Do not interpret the lower subjective scores in the weak group as proof that hip strength directly causes better outcomes. The groups differed significantly in age, weight, and BMI, and the subjective differences were small enough that they may not be clinically meaningful to the patient.