Hop to It! A Systematic Review and Longitudinal Meta-analysis of Hop Performance After ACL Reconstruction.

Adam G Culvenor, Ebonie K Rio, Kay M Crossley, Michael A Girdwood, Brooke E Patterson, Melissa J Haberfield, Jamon L Couch, Benjamin F Mentiplay, Michael Hedger

Journal: Sports medicine (Auckland, N.Z.) 2025;55(1):101-113

PMID: 39414723

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Abstract

BACKGROUND

Hop testing is widely used by clinicians to monitor rehabilitation and decide when to return to sport following anterior cruciate ligament reconstruction (ACLR); however, the trajectory of long-term hop performance has not been summarised.

OBJECTIVE

To investigate hop performance change over time after ACLR.

DESIGN

Systematic review with longitudinal meta-analysis.

DATA SOURCES

MEDLINE, EMBASE, CINAHL, Scopus, Cochrane CENTRAL and SPORTDiscus to 28 February 2023.

ELIGIBILITY CRITERIA

Studies with ≥ 50 participants following primary ACLR, with mean participant age of 18-40 years, reporting a quantitative measure of hop performance (e.g. single forward hop distance). Results had to be reported for the ACLR limb and compared with (1) the contralateral limb (within person) and/or (2) an uninjured control limb (between person).

RESULTS

We included 136 studies of 23,360 participants. Performance was similar across different hop tests, with steep initial improvements in within-person symmetry, tailing off after 18-24 months. ACLR limb hop performance was 5-10% lower compared with the contralateral limb at 1 year post-surgery, with largest deficits observed for vertical hop [87.0% contralateral limb (95% CI 85.3-88.8) compared with single forward hop 93.8% (95% CI 92.8-94.9)]. By 3-5 years, results were similar between ACLR and contralateral limbs. There were limited data for between-person comparisons (n = 17 studies). Exploratory analyses showed deficits in all forward hopping tests to be very strongly correlated with each other [e.g. single forward and triple hop rho = 0.96 (95% CI 0.90-0.99)], though there was discordance in the relationship between single forward hop and vertical hop performance [rho = 0.27 (95% CI - 0.53 to 0.79)].

CONCLUSIONS

Hop performance is comparable to the uninjured limb by 3-5 years post-ACLR, with the greatest deficits in within-person symmetry present in vertical and side hop tests. Assessment of hopping in multiple planes and comparison with uninjured controls, may provide the most complete evaluation of functional performance.

Address: La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, VIC, 3086, Australia. [email protected].; La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, VIC, 3086, Australia.; La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, VIC, 3086, Australia.; The Australian Ballet, Victoria, Australia.; The Victorian Institute of Sport, Victoria, Australia.; La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, VIC, 3086, Australia.; Arthritis Research Canada, Vancouver, BC, Canada.; La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, VIC, 3086, Australia.; Sport, Performance, and Nutrition Research Group, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia.

DOI: 10.1007/s40279-024-02121-1

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https://dx.doi.org/10.1007/s40279-024-02121-1

MeSH Terms: Humans, Anterior Cruciate Ligament Reconstruction, Anterior Cruciate Ligament Injuries, Return to Sport, Exercise Test, Longitudinal Studies