Wearable Devices for the Quantitative Assessment of Knee Joint Function After Anterior Cruciate Ligament Injury or Reconstruction: A Scoping Review
Oliwia Ptaszyk, Tarek Boutefnouchet, Gerard Cummins, Jin-Min Kim, Ziyun Ding
Abstract
Anterior cruciate ligament (ACL) injury and reconstruction (ACLR) are associated with biomechanical deficits and reinjury risk. Wearable devices offer promising tools for objective assessment of knee joint function. This scoping review aimed to map the use of wearable devices in quantifying knee outcomes following ACL injury or reconstruction, and to evaluate their clinical readiness and methodological quality. Eligible studies were human, English-language studies in ACL/ACLR populations or healthy cohorts assessing ACL-relevant knee outcomes with wearable devices. MEDLINE (Ovid), Embase (Ovid), APA PsycInfo (Ovid), PubMed, and Scopus were searched up to 27 August 2025. Data on devices, tasks, participants, outcomes, and validation were extracted, and an adapted technology readiness level (TRL) mapping was applied. Thirty-two studies met the inclusion criteria. Inertial measurement units (IMUs) were used most often for kinematics. Standalone accelerometers quantified pivot-shift features, while force-sensing insoles captured bilateral loading. Electromagnetic trackers and electrogoniometers served as higher-precision comparators but were workflow-limited. Reporting of calibration and criterion validation was inconsistent. TRL bands clustered at 3-6, and none reached clinical integration. We propose task-matched sampling, transparent calibration, criterion validation, pairing with patient-reported outcome measures (PROMs), and multi-site workflow trials to progress towards routine care.