Cruciate Ligament (ACL) Screening Examination
tool has been developed, through clinical research conducted at the University
of Delaware, to help identify those patients with ACL tears who have good
potential to temporarily return to high-level activities after ACL injury(1).
Often, athletes or those who work in physically demanding occupations are
not given an option to delay ACL surgical reconstruction. This could mean
the loss of an athletic scholarship, or the loss of substantial income
if the injury occurs during a busy work season. However, the risk
of extending the injury upon return to high level activities
be minimized. The ACL screening examination provides criteria to distinguish
those individuals who may be given the option to delay ACL surgical reconstruction.
must meet the following requirements in order to qualify for participation
in the ACL screening examination: 1) no ligamentous injury in the opposite
knee, 2) no significant injury to knee ligaments other than the ACL, 3)
no repairable meniscal damage. Patients must have a physician referral
in order to participate in the ACL screening examination.
ACL screening examination consists of the following:
2000 arthrometer testing: this instrument measures the laxity in the knee
resulting from the ACL injury
strength testing: this test requires patients to produce a maximum voluntary
isometric contraction of the quadriceps during which a short burst of electrical
stimulation is delivered to the muscle
four different types of single leg hop tests are performed (single hop
for distance, triple cross-over hop, triple hop and timed hop) on both
sides. A functional brace is worn during testing.
of function questions: a questionnaire and a global rating score measure
the functional level of the patient
completion of the ACL screening examination, the results are reviewed with
the patient. Those patients who pass the ACL screening examination are
required to participate in 10 sessions of perturbation training, a form
of balance training. Those patients who fail the ACL screening examination
are recommended to pursue operative management.
further information about the ACL screening examination, please contact
Chmielewski, at (302) 831-4646.
GK, Knee Surg Traumtol Arthrosc, in press