MERItest^TM-A multidimensional model for functional evaluation at 6 months after ACL reconstruction

Area of Science:

• Orthopedics
• Sports Medicine
• Rehabilitation Science

Background:

• Athletes face high re-injury risk 6 months post-anterior cruciate ligament reconstruction (ACLR) during the transition to sport-specific training.
• Current clinical assessments often use unidimensional metrics (e.g., hop distance, limb symmetry index) that fail to identify underlying neuromechanical deficits.
• This gap contributes to persistent re-injury rates, even in athletes meeting conventional return-to-sport criteria.

Purpose of the Study:

• To introduce the MERItest™, a structured, multidimensional evaluation framework for enhanced clinical reasoning at the 6-month post-ACLR milestone.
• To integrate isometric strength, 3D biomechanical analysis, and psychological readiness into a unified interpretive model.
• To shift from checklist-based clearance to multidimensional profiling for individualized recovery assessment.

Main Methods:

• The MERItest™ integrates three domains: monoarticular isometric strength testing, 3D biomechanical analysis of functional tasks (jumping, hopping, running), and psychological readiness using the ACL-RSI questionnaire.
• Isometric testing quantifies muscle contractile capacity.
• 3D biomechanics captures dynamic movement strategies and coordination, while psychological assessment evaluates confidence and risk appraisal.

Main Results:

• The framework enables the identification of residual deficits and compensatory strategies missed by performance-based testing alone.
• It examines not only force production but also movement organization and subjective experience.
• The MERItest™ supports a move towards individualized interpretation of recovery patterns.

Conclusions:

• The MERItest™ provides a more comprehensive assessment of functional readiness post-ACLR than traditional methods.
• It enhances clinical reasoning by offering a multidimensional profile of an athlete's recovery.
• This framework reframes the 6-month evaluation as a diagnostic opportunity to optimize return-to-sport decisions and potentially reduce re-injury rates, pending prospective validation.