Classification of functional recovery of Anterior Cruciate Ligament copers, non-copers and adapters

Kate Button ¹, Robert van Deursen ^1* and Patricia Price ²

¹ Cardiff University, United Kingdom
² Wound Healing Reseaech Unit, United Kingdom

^* To whom correspondence should be addressed. E-mail: vandeursenr{at}cardiff.ac.uk.

Accepted 5 July 2006

Abstract

OBJECTIVES: (1) To identify whether differences exist in the pattern of recovery with respect to functional outcomes for acutely ruptured anterior cruciate ligament deficient (ACLD) copers, adapters and non-copers. (2) To identify clinically relevant outcomes that could distinguish between 3 functional sub-groups.

METHODS: A longitudinal study was used to measure gait variables and distance hop at regular intervals following injury using a digital camcorder and computer for quantitative analysis. A sample of 63 ACLD subjects entered the study, 42 subjects were measured at least 3 times. At 12 to 36 months post injury individuals were classified as functional copers, adapters or non-copers based on which of their pre-injury activities they had resumed. To determine the pattern of recovery, repeated measurements were analysed using a least square fit of the data.

RESULTS: 17% of ACLD subjects were classified as functional copers, 45% as adapters and 38% as non-copers. Only 5% of people who participated in high demand activities pre-injury returned to them. ACLD copers recovered above the control mean for all gait variables by 40 days post injury. Hopping distance did not recover to the control mean. Non-copers struggled to recover to control limits and remained border line for all the gait variables.

CONCLUSIONS: Distinctive patterns of functional recovery for 3 sub-groups of ACL subjects have been identified. Gait variables and pre-injury activity level were the most useful variables to distinguish between the sub-groups. If an individuals potential for recovery is identifiable early post injury then appropriate treatment can be given.

Key Words: anterior cruciate ligament, function, measurement, recovery, rehabilitation

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