Evaluation of proprioceptive balance results of amateur athletes following anterior cruciate ligament reconstruction: Hamstring autograft

Year 2022, Volume: 5 Issue: 6, 1606 - 1611, 25.10.2022

Nizamettin Güzel , Ahmet Serhat Genç , Lokman Kehribar , Ali Kerim Yılmaz

https://doi.org/10.32322/jhsm.1175181

Cited By: 1

Abstract

Aim: Anterior cruciate ligament (ACL) is one of the main ligaments which provide mechanical stability of the knee, control the anteroposterior translation and rotation movements and play a key role in neuromuscular stability. The aim of the present study is to compare the 6th month balance results on operated and non-operated sides of athletes who underwent ST/G anterior cruciate ligament reconstruction (ACL).
Material and Method: The study was evaluated as a retrospective cohort consisting of patients who underwent semitendinosus/gracilis hamstring autograft (ST/G) ACL reconstruction (n=24) technique between May 2020 and October 2021. CSMI-TecnoBody PK-252 was used to determine the 6th month post-operative static balance measurements of patients. The tests were applied to both ACLR side and contralateral healthy side.
Results: Compared to pre-operative levels, there was a significant improvement in the mean Lysholm, Tegner, and IKDC scores at the post-operative level (p<0.05). No significance was found between 6th month post-operative static balance results of the subjects on ACLR side and contralateral healthy side (p>0.05).
Conclusion: It is seen that 6 month post-operative findings of ST/G ACLR technique show similar results with the healthy contralateral side. This result is valuable in terms of balance scores showing similar results for both sides.

Keywords

proprioception, balance, postural control, ACL reconstruction, athletes

References

• Furlanetto TS, Peyré-Tartaruga LA, Pinho ASD, Bernardes EDS, Zaro MA. Proprioception, body balance, and functionality in individuals with ACL reconstruction. Acta Ortopedica Brasileira 2016; 24: 67-72.
• Adachi N, Ochi M, Uchio Y, Iwasa J, Kuriwaka M, Ito Y. Reconstruction of the anterior cruciate ligament. J Bone Joint Surg Br 2004; 86: 515-20.
• Anders JO, Venbrocks RA, Weinberg M. Proprioceptive skills and functional outcome after anterior cruciate ligament reconstruction with a bone-tendon-bone graft. Int Orthop 2008; 32: 627-33.
• Fremerey RW, Lobenhoffer P, Zeichen J, Skutek M, Bosch U, Tscherne H. Proprioception after rehabilitation and reconstruction in knees with deficiency of the anterior cruciate ligament: a prospective, longitudinal study. J Bone Joint Surg Br 2000; 82: 801-6.
• Hohmann E, Bryant A, Tetsworth K. Strength does not influence knee function in the ACL-deficient knee but is a correlate of knee function in the and ACL-reconstructed knee. Archives of orthopaedic and trauma surgery 2016; 136: 477-83.
• Palmieri-Smith RM, Thomas AC. A neuromuscular mechanism of posttraumatic osteoarthritis associated with ACL injury. Exercise and sport sciences reviews 2009; 37: 147-53.
• Akbari A, Ghiasi F, Mir M, Hosseinifar M. The effects of balance training on static and dynamic postural stability indices after acute ACL reconstruction. Global journal of health science 2016; 8: 68.
• Madhavan S, Shields RK. Neuromuscular responses in individuals with anterior cruciate ligament repair. Clin Neurophysiol 2011; 122: 997-1004.
• Machotka Z, Scarborough I, Duncan W, Kumar S, Perraton L. Anterior cruciate ligament repair with LARS (ligament advanced reinforcement system): a systematic review. Sports Med Arthrosc Rehabil Ther Technol 2010; 2: 29.
• Shaffer SW, Harrison AL. Aging of the somatosensory system: a translational perspective. Phys Ther 2007; 87: 193-207.
• Zouita Ben Moussa A, Zouita S, Dziri C, Ben Salah FZ. Single-leg assessment of postural stability and knee functional outcome two years after anterior cruciate ligament reconstruction. Ann Phys Rehabil Med 2009; 52: 475-84.
• Cooper RL, Taylor NF, Feller JA. A randomised controlled trial of proprioceptive and balance training after surgical reconstruction of the anterior cruciate ligament. Research in Sports Medicine 2005; 13: 217-30.
• Kehribar L, Yılmaz, AK, Karaduman E, et al. Post-operative results of ACL reconstruction techniques on single-leg hop tests in athletes: hamstring autograft vs. hamstring grafts fixed using adjustable cortical suspension in both the femur and tibia. Medicina 2022; 58: 435.
• Kehribar L, Coşkun HS, Yılmaz AK, et al. Examination of ısokinetic knee strength and hamstring/quadriceps ratios in ındividuals with anterior cruciate ligament ınjury: ACL ınjured knee versus non-ınjured knee 2022; 14: 158-62.
• Risberg MA, Holm I, Myklebust G, Engebretsen, L. Neuromuscular training versus strength training during first 6 months after anterior cruciate ligament reconstruction: a randomized clinical trial. Phys Ther 2007; 87: 737-50.
• Zhou MW, Gu L, Chen YP, et al. Factors affecting proprioceptive recovery after anterior cruciate ligament reconstruction. Chin Med J (Engl) 2008; 121: 2224-8.
• .Muaidi QI, Nicholson LL, Refshauge KM, Adams RD, Roe JP. Effect of anterior cruciate ligament injury and reconstruction on proprioceptive acuity of knee rotation in the transverse plane. Am J Sports Med 2009; 37: 1618-26.
• Middleton KK, Hamilton T, Irrgang, JJ, Karlsson J, Harner CD, Fu FH. Anatomic anterior cruciate ligament (ACL) reconstruction: a global perspective. Part 1, Knee Surger Y. Sports Traumatology, Arthroscopy 2014; 22: 1467-82.
• Gokalp O, Akkaya S, Akkaya N, et al. Preoperative and postoperative serial assessments of postural balance and fall risk in patients with arthroscopic anterior cruciate ligament reconstruction. J Back Musculoskeletal Rehab 2016; 29: 343-50.
• Bodkin SG, Slater LV, Norte GE, Goetschius J, Hart, JM. ACL reconstructed individuals do not demonstrate deficits in postural control as measured by single-leg balance. Gait & posture 2018; 66: 296-9.
• Parus K, Lisiński P, Huber J. Body balance control deficiencies following ACL reconstruction combined with medial meniscus suture. A preliminary report. Orthopaedics & Traumatology: Surgery & Research 2015; 101: 807-10.
• Howells BE, Clark RA, Ardern CL, et al. The assessment of postural control and the influence of a secondary task in people with anterior cruciate ligament reconstructed knees using a Nintendo Wii Balance Board. British J Sports Med 2013; 47: 914-9.
• Bonfim TR, Paccola CA, Barela JA. Proprioceptive and behavior impairments in individuals with anterior cruciate ligament reconstructed knees. Arch Phys Med Rehab 2003; 84: 1217–23.
• Denti M, Randelli P, Lo Vetere D, et al. Motor control performance in the lower extremity: normals vs. anterior cruciate ligament reconstructed knees 5–8 years from the index surgery. Knee Surg Sports Traumatol Arthrosc 2000; 8: 296–300.
• Hoffman M, Schrader J, Koceja D. An investigation of postural control in postoperative anterior cruciate ligament reconstruction patients. J Athl Train 1999; 34: 130–6.
• Chmielewski TL, Wilk KE, Snyder-Mackler L. Changes in weight-bearing following injury or surgical reconstruction of the ACL: relationship to quadriceps strength and function. Gait Posture 2002; 16: 87–95.
• Gauffin H, Pettersson G, Tegner Y, Tropp H. Function testing in patients with old rupture of the anterior cruciate ligament. Int J Sports Med 1990; 11: 73–7.
• Friden T, Zatterstrom R, Lindstrand A, Moritz U. Anterior-cruciate-insufficient knees treated with physiotherapy. A 3-year follow-up study of patients with late diagnosis. Clin Orthop Relat Res 1991; 263: 190–9.
• Kapreli E, Athanasopoulos S, Gliatis J, et al. Anterior cruciate ligament deficiency causes brain plasticity: a functional MRI study. Am J Sports Med 2009; 37: 2419–26.
• Melnyk M, Faist M, Gothner M, Claes L, Friemert B. Changes in stretch reflex excitability are related to ‘giving way’ symptoms in patients with anterior cruciate ligament rüptüre. J Neurophysiol 2007; 97: 474–80.
• Dyhre-Poulsen P, Krogsgaard MR. Muscular reflexes elicited by electrical stimulation of the anterior cruciate ligament in humans. J Appl Physiol 2000; 89: 2191–5.
• Riesterer J, Mauch M, Paul J, Gehring D, Ritzmann R, Wenning M. Relationship between pre-and post-operative isokinetic strength after ACL reconstruction using hamstring autograft. BMC Sports Sci. Med. Rehabilitation 2020; 12: 1-10.
• Fischer F, Fink C, Herbst E, Hoser C, Hepperger C, Blank C, Gföller P. Higher hamstring-to-quadriceps isokinetic strength ratio during the first post-operative months in patients with quadriceps tendon compared to hamstring tendon graft following ACL reconstruction. Knee Surg. Sports Traumatol. Arthrosc 2018; 26: 418-425.