Motion Alterations After Anterior Cruciate Ligament Reconstruction: Comparison of the Injured and Uninjured Lower Limbs During a Single-Legged Jump

Context: Asymmetries subsist after anterior cruciate ligament reconstruction (ACL-R), and it is unclear how lower limb motion is altered in the context of a dynamic movement. Objective: To highlight the alterations observed in the injured limb (IL) during the performance of a dynamic movement after ACL-R. Design: Cross-sectional study. Setting: Research laboratory. Patients or Other Participants: A total of 11 men (age = 23.3 ± 3.8 years, mass = 81.2 ± 17.0 kg) who underwent ACL-R took part in this study 7.3 ± 1.1 months (range = 6–9 months) after surgery. Intervention(s): Kinematic and kinetic analyses of a single-legged squat jump were performed. The uninjured leg (UL) was used as the control variable. Main Outcome Measure(s): Kinematic and kinetic variables. Results: Jump height was 24% less for the IL than the UL (F1,9 = 23.3, P = .001), whereas the push-off phase duration was similar for both lower limbs (P = .96). Knee-joint extension (F1,9 = 11.4, P = .009), and ankle plantar flexion (F1,9 = 22.6, P = .001) were less at takeoff for the IL than the UL. The hip angle at takeoff was not different between lower limbs (P = .09). We found that total moment was 14% less (F1,9 = 11.1, P = .01) and total power was 35% less (F1,9 = 24.2, P = .001) for the IL than the UL. Maximal hip (P = .09) and knee (P = .21) power was not different between legs. The IL had 34% less maximal ankle power (F1,9 = 11.3, P = .009) and 31% less angular velocity of ankle plantar flexion (F1,9 = 17.8, P = .004) than the UL. Conclusions: At 7.3 months after ACL-R, motion alterations were present in the IL, leading to a decrease in dynamic movement performance. Enhancing the tools for assessing articular and muscular variables during a multijoint movement would help to individualize rehabilitation protocols after ACL-R.

Download Full-text

Revision Anterior Cruciate Ligament Reconstruction

The American Journal of Sports Medicine ◽

10.1177/0363546506318189 ◽

2008 ◽

Vol 36 (10) ◽

pp. 1896-1902 ◽

Cited By ~ 8

Author(s):

Matteo Denti ◽

Dario Lo Vetere ◽

Corrado Bait ◽

Herbert Schönhuber ◽

Gianluca Melegati ◽

...

Keyword(s):

Anterior Cruciate Ligament ◽

Anterior Cruciate Ligament Reconstruction ◽

Ligament Reconstruction ◽

Cruciate Ligament ◽

Case Series ◽

Lower Limbs ◽

Cruciate Ligament Reconstruction ◽

Anterior Cruciate ◽

Positive Results

Background Revision of an anterior cruciate ligament reconstruction is a complicated and delicate clinical procedure whose results, theoretically, are less satisfactory than those of the first operation. Hypothesis The outcome of a revised anterior cruciate ligament surgery is comparable to primary anterior cruciate ligament reconstruction, with a rate of success around 70% to 80%. Study Design Case series; Level of evidence, 4. Methods A total of 66 revisions of anterior cruciate ligament reconstructions were carried out from September 2000 to September 2004. Patients with concomitant instability and those with alterations in the weightbearing axis of the lower limbs were not included. Sixty patients were followed from 24 to 72 months: 50 clinically and 10 by a phone interview. Six patients were lost to follow-up due to changes of address. Results Lysholm scores were 57% excellent (95–100 points), 13% good (84–94 points), 22% fair (63–83 points), and 8% poor (<64 points). A total of 68% of patients had negative Lachman tests, 20% had positive tests with a hard end point, 10% had positive results, and 2% had very positive results. Stabilometric evaluation with the KT-1000 arthrometer at the maximum load showed that 56% of patients had <3 mm side-to-side difference, 34% had between 3 and 5 mm, and 10% had 6 to 10 mm. The International Knee Documentation Committee scores were 36% excellent (class A), 46% good (class B), and 18% fair (class C). The percentage of patients who resumed sport at the same level was 78%, compared with 58% after their primary reconstruction. Conclusion The results of these anterior cruciate ligament reconstruction revision surgeries are close to those achieved by other series of primary reconstructions with a little less satisfactory results. We attribute the high success rate to the strict application of the same technique and the confinement of revision to motivated patients. It should be noted, however, that follow-up is only at the midterm stage (mean, 41.9 months).

Download Full-text