Pre- and postoperative postural regulation following anterior cruciate ligament reconstruction

Abstract

There are currently no longitudinal data describing the pre- and postop-erative postural regulation and stability of patients with anterior cruci-ate ligament (ACL) damage. Therefore, the aim of this study was to evaluate postural regulation and stability prior to and during rehabilita-tion following surgery of the ACL. Fifty-four physically active subjects (age: 30.5±10.9 years, 29 male subjects) were examined with the Inter-active Balance System pre-, 6, and at 12 weeks following surgical re-construction of the ACL using a hamstring tendon graft. The average period of time from injury to surgery was 27 days. Data were calculated with unifactorial and univariate analysis of variance. Significant effects were found for the somatosensory system (η2=0.115), stability indicator (η2=0.123), weight distribution index (η2=0.176), and synchronization (foot coordination) (η2=0.249). Involved side weight distribution (param-eter: left) increased significantly (patients with left-sided/right-sided in-jury: η2=0.234/0.272). Load distribution to the heel remained stable during all three examination periods (η2=0.035 and η2=0.071), although a remarkable load at forefoot was observed. In seven out of 10 parame-ters partial effects were seen during the first 6 weeks after surgery. The results of this study indicated that injury of the ACL and subsequent surgical reconstructions result in postural regulation, with improve-ments in somatosensory system function, postural stability, weight dis-tribution index, and foot coordination. Also, overloading of the injured side on the feet reduces significantly during rehabilitation. Thus, the ini-tial phase of rehabilitation (weeks 1 to 6) seems to be more effective than the second period (weeks 6 to 12) postoperatively.