ASSOCIATION BETWEEN PATIENT-REPORTED OUTCOMES AND HOP PERFORMANCE IN ADOLESCENTS WITH AN ANTERIOR CRUCIATE LIGAMENT-DEFICIENT KNEE

Physical readiness to return to sport after anterior cruciate ligament (ACL) injury and associated treatments and surgery is often assessed using a battery of tests, including hop test performance. However, patient-reported outcome measures (PROMs) also serve an important role as they are linked to psychological readiness for returning to sports and can predict clinical and return to sport outcomes. However, the PROMs commonly used as part of criteria for return to sport in adolescents and pediatric patients still requires further investigation. The purpose of this study was to identify the relationship between PROMs and hop performance in male and female ACL Deficient (ACLD) pediatric patients. Patients from a pediatric orthopaedic sports medicine practice found to have a complete ACL tear were prospectively enrolled in a larger cohort including objective testing pre-operatively. We assessed symptoms, activities, and total score of the International Knee Documentation Committee (IKDC) as indicators of knee function, and the total score of the Pediatric Functional Activity Brief Scale (PEDI-FABS) as an indicator of physical activity level. The maximal distances achieved in single, lateral, crossover, and triple hop tests normalized to leg length and the lower time in timed 6-meter with the injured leg were analyzed. Linear regression was used to determine the association between PROMs and hop test performance for females and males separately using SPSS 26.0 (IBM Corp, USA), with α set at 0.05. The global effect size (ƒ²) was also calculated, with the following interpretation: small (≥0.02), medium (≥0.15), and large (≥0.35). Sixty-five ACLD females [age:15.2(1.5) years, height:1.65(0.06) m, weight:64.6(11.7) kg] and 28 ACLD males [age:15.6(1.4) years, height:1.74(0.09) m, weight:72.4(16.9) kg] completed PROMs and underwent a battery of hop tests. Among ACLD females, a medium association was observed between (1) IKDC total score and the single hop test (Figure-1A), (2) PEDI-FABS score and the lateral hop (Figure-1B); a small association between (3) PEDI-FABS score and crossover (Figure-1C), (4) PEDI-FABS score and triple hop tests (Figure-1D). However, for ACLD males, no associations were found between the PROMs and hop test performance. In adolescent ACLD females, PROMs present small to medium associations with hop performance; however, this was not present in males. We therefore conclude that patient self-perception of their physical activity level and knee function as evaluated through PROMs does not necessarily reflect their functional capacity and hop performance. We also found evidence that male and female ACLD adolescents respond differently to clinical evaluations. Our findings also suggest that commonly used tools in adults may not be directly applicable to pediatric ACLD patients. For any figures or tables, please contact the authors directly.