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Anterior Cruciate Ligament (ACL) Screening Examination

A screening 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

must be minimized. The ACL screening examination provides criteria to distinguish those individuals who may be given the option to delay ACL surgical reconstruction.

Patients 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.

The ACL screening examination consists of the following:

  •  KT 2000 arthrometer testing: this instrument measures the laxity in the knee resulting from the ACL injury
  • Quadriceps 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
  • Hop testing: 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.
  • Self-report of function questions: a questionnaire and a global rating score measure the functional level of the patient

  • After 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.

    For further information about the ACL screening examination, please contact Terri Chmielewski, at (302) 831-4646.

    1 Fitzgerald GK, Knee Surg Traumtol Arthrosc, in press

    053 McKinly Laboratory | University of Delaware | Newark, DE 19716 | phone 302-831-8893 | fax 302-831-4468
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    last edited June, 2000