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Unilateral tests of lower-limb function as prognostic indicators of future knee-related outcomes

Brief summary, from the abstract

This systematic review and meta-analysis of 42 studies (13,150 people) found that better hop-test limb symmetry after an ACL injury predicts more favourable knee-related outcomes, including return to sport, self-reported function, and lower osteoarthritis risk, though the overall certainty of evidence is very low.

  • Greater single-forward and repeated-forward hop symmetry was linked to higher odds of returning to sport 1 to 3 years after ACL reconstruction (OR 2.15; 95% CI 1.30 to 3.54; and OR 2.11; 95% CI 1.23 to 3.60).
  • Better hop symmetry was associated with improved self-reported symptoms and function 1 to 37 years after injury (single-forward OR 2.51; 95% CI 1.62 to 3.88; repeated-forward OR 4.28; 95% CI 1.65 to 11.08).
  • Reaching at least 90% symmetry on the single-forward hop was tied to lower odds of knee osteoarthritis 5 to 37 years later (OR 0.46; 95% CI 0.23 to 0.94).
  • The authors graded the evidence as very low certainty, so these tests should guide rather than dictate rehabilitation decisions.
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