Validity of the SHD-LESS Scale After ACL Reconstruction (ACL-LESS)

March 27, 2026 updated by: Joffrey DRIGNY, University Hospital, Caen

Validity of the SHD-LESS Scale in Detecting Landing Asymmetry and Its Association With Functional Status After ACL Reconstruction.

After anterior cruciate ligament reconstruction (ACL-R), Single Hop for Distance (SHD) performance aids in decision-making, particularly for return-to-sport assessments. However, asymmetrical landing kinematics are common after ACL-R, even with symmetrical performances, and increase the risk of re-injury. To support clinical practice, several qualitative scales have been developed as valid and reliable tools for assessing landing quality. In 2022, Measson et al. adapted the Landing Error Scoring System for use during an SHD task (SHD-LESS scale) and demonstrated its reliability among healthy individuals.

The aim of this study is to test the validity of this scale after ACL-R by evaluating its ability to identify asymmetrical landing and characterize differences between the operated and uninjured limb. The second objective is to assess its association with knee muscle strength, functional status and psychological readiness.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Study Type

Observational

Enrollment (Actual)

60

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • France
      • Caen, France
        • Service de Médecine du sport, CHU Caen

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult

Accepts Healthy Volunteers

No

Sampling Method

Non-Probability Sample

Study Population

All sports patients included in the sport medicine follow-up protocole with isokinetic muscular assessment at 6-12 months after ACL reconstruction surgery since March 2024 in the sports medicine department (Return To Sport Process)

Description

Inclusion Criteria:

  • Patients aged 18-40, who have undergone a first ACL reconstruction more than 6 months ago and are being followed in a sports medicine care pathway
  • Affiliated with a health insurance plan
  • Information form: Non-objection to the use of data for research purposes

Exclusion Criteria:

  • Previous ligament surgery of the lower limbs prior to ACL reconstruction
  • Complex ligament injury (lateral ligaments, posterior cruciate ligament)
  • Recent muscle injuries
  • History of injury to the uninjured knee
  • Pregnant woman
  • Inability to perform a muscular assessment
  • Postoperative complications (deep vein thrombosis, sepsis, stiffness/arthrofibrosis)
  • Neurological history with residual effects or taking medication that affects balance/coordination

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

Cohorts and Interventions

Group / Cohort
Intervention / Treatment
ACL reconstruction group
All sports patients who had a muscle evaluation at 6 to 12 months after ACLR since March 2024
Diagnostic test: Landing error assessment during a SHD task using the SHD-LESS scale
Participants will perform a 2D-camera-recorded SHD task, with the SHD-LESS scored by two sports medicine physicians. Additional tests include isokinetic muscle testing, as well as functional and psychological status assessments, following standard clinical practice.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Single Hop for Distance, Landing Error Scoring System (SHD-LESS) scale
Time Frame: One measurement during the visit at 6 to 12 months after surgery
The LESS (Landing Error Scoring System) scale is a 13-item tool used to assess landing technique during a hop task.
One measurement during the visit at 6 to 12 months after surgery

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
ACL-RSI questionnaire (Anterior Cruciate Ligament-Return to Sport after Injury)
Time Frame: One measurement during the visit at 6 to 12 months after surgery
The ACL-RSI measures the patient's understanding of his knee. It comprises 12 questions with a score of 1 to 10 for each
One measurement during the visit at 6 to 12 months after surgery
Strength
Time Frame: One measurement during the visit at 6 to 12 months after surgery
Measurement of knee extensors and flexors peak strength (in newton.meter, Nm) on isokinetic dynamometer
One measurement during the visit at 6 to 12 months after surgery
International Knee Documentation Committee (IKDC) score
Time Frame: One measurement during the visit at 6 to 12 months after surgery
Knee level of function based on patient-reported measures from symptoms to daily activities. The IKDC score includes sections on knee symptoms (7 items), function (2 items), and sports activities (2 items), with scores ranging from 0 (lowest function, highest symptoms) to 100 (highest function, lowest symptoms).
One measurement during the visit at 6 to 12 months after surgery

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

University Hospital, Caen

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

March 1, 2024

Primary Completion (Actual)

October 2, 2025

Study Completion (Actual)

November 15, 2025

Study Registration Dates

First Submitted

February 11, 2025

First Submitted That Met QC Criteria

February 11, 2025

First Posted (Actual)

February 17, 2025

Study Record Updates

Last Update Posted (Actual)

April 1, 2026

Last Update Submitted That Met QC Criteria

March 27, 2026

Last Verified

March 1, 2026

More Information

Terms related to this study

Additional Relevant MeSH Terms

Other Study ID Numbers

  • ACL-LESS

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

UNDECIDED

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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