Which Hop Tests Can Best Identify Functional Limb Asymmetry in Patients 9-12 Months After Anterior Cruciate Ligament Reconstruction Employing a Hamstrings Tendon Autograft?

This was a cross-sectional study of 50 patients after surgery, not a randomized trial or a return-to-sport outcome study. Patients were selected for a narrow window: 16-50 years of age, 9-12 months after hamstrings autograft ACL reconstruction, and free of ongoing knee or other musculoskeletal problems. Some patients had concomitant meniscectomy or meniscal repair, so the group was not limited to isolated ACL reconstruction. The less common hop tests did not have healthy normative values in this paper, so a 90% symmetry cut-off may not be appropriate for them. Patients received varied rehabilitation guidance and exercise prescription, and no objective criteria were used to clear them for participation. Warm-up stretching and rest between trials were not standardized, so fatigue or preparation may have affected some scores. Limb symmetry can overestimate function because the non-operated limb may also be deconditioned. The study measured distance, height or time, not movement quality or biomechanics, and did not test whether adding these hop tests reduces re-injury.

The authors reported no commercial benefits, no funding and no conflicts of interest. Ethics approval was obtained.

Do not conclude that the side, vertical and agility hop tests are proven better clearance tests. They showed lower symmetry in more patients, but the study did not compare them with healthy norms, did not link their scores to re-injury, and did not show that using them changes return-to-sport decisions.