Single-leg hop test may predict odds of persistent patellar instability
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Key takeaways:
- Limb symmetry index for single-leg hop and triple hop movements was significantly associated with persistent patellar instability.
- Clinicians may use these tests to assess patients’ risk for future instability.
According to published results, limb symmetry index for baseline single-leg hop for distance and triple hop for distance was significantly associated with persistent patellar instability at 1-year follow-up.
Researchers retrospectively analyzed data from 61 patients (mean age of 19.2 years) with recurrent lateral patellar dislocation who were treated with medial patellofemoral ligament reconstruction and active rehabilitation or active rehabilitation alone.
According to the study, researchers calculated limb symmetry index for each leg while patients performed several functional movements: single-leg hop for distance, triple hop for distance, crossover hop for distance and 6-meter timed hop. Primary outcome measure was persistent patellar instability at 1-year follow-up.
Overall, researchers found limb symmetry index for baseline single-leg hop for distance (OR = 0.94) and the triple hop for distance (OR = 0.91) was significantly associated with persistent patellar instability at 1 year. Researchers noted no other significant associations between movements and patellar instability.
“Clinicians can use results from these hop tests to assess the risk of future recurrent patellar instability prior to treatment,” the researchers wrote in the study.
Perspective
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This study by Tina Løkken Nilsgård and colleagues highlights an important and understudied topic in the role of rehabilitation and functional testing during the treatment of patellar instability. The authors concluded that baseline functional measures can predict outcomes after the treatment of patellar instability, although further information is needed to understand whether baseline deficits reflect long-standing symptoms or more severe pathology that may also be correlated to outcomes. While the authors noted that the odds ratios for reporting persistent instability were 0.96 and 0.94 for baseline single and triple hop tests, respectively, the clinical significance of this amount of risk reduction requires further study.
Regardless, understanding whether baseline functional testing could be and should be improved prior to surgical stabilization is an important goal as we continue to refine our approach to managing this condition. Such findings could ultimately influence how we incorporate “prehab” prior to patellofemoral surgery and help to optimize treatment guidelines in the management of patellar instability.
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