Excessive tibial rotation during high-demand activities is not restored by anterior cruciate ligament reconstruction

Stavros Ristanis, Nicholas Stergiou, Kostas Patras, Haris S. Vasiliadis, Giannis Giakas, Anastasios D. Georgoulis

Research output: Contribution to journalArticle

167 Citations (Scopus)

Abstract

Purpose: Recent in vitro research has suggested that anterior cruciate ligament (ACL) reconstruction does not restore control of tibial rotation. The purpose of this study was to explore these findings in vivo and investigate rotational knee stability during landing and subsequent pivoting. Such an activity places higher demands on the knee, almost similar to those found during high-level sports. Type of Study: Case control series study. Methods: We assessed 11 patients who had undergone ACL reconstruction with the same arthroscopic technique using a bone-patellar tendon-bone graft, 11 ACL-deficient subjects who had sustained the injury more than 1 year prior to testing, and 11 matched controls. Kinematic data were collected (50 Hz) with a 6-camera optoelectronic system while the subjects performed the following task: they jumped off a 40-cm platform and landed on the ground. After foot contact, the subjects were instructed to pivot at 90°and walk away from the platform. The evaluation period was identified from initial foot contact with the ground with both legs, included the pivoting of the ipsilateral leg, and was completed on touchdown of the contralateral leg. Results: Significant differences were found between the reconstructed leg of the ACL group and the healthy control, and between the deficient leg of the ACL-deficient group and the healthy control. We also found no significant differences between the deficient leg of the ACL-deficient group and the reconstructed leg of the ACL reconstructed group. Conclusions: It was concluded that, under high-stress activities, ACL reconstruction may not restore tibial rotation to the previous physiological level, even though anterior tibial translation is restored. Future research on ACL reconstruction should focus on the development of new surgical procedures and/or grafts to address this problem. Level of Evidence: Level III.

Original languageEnglish (US)
Pages (from-to)1323-1329
Number of pages7
JournalArthroscopy - Journal of Arthroscopic and Related Surgery
Volume21
Issue number11
DOIs
StatePublished - Nov 1 2005

Fingerprint

Anterior Cruciate Ligament Reconstruction
Leg
Anterior Cruciate Ligament
Foot
Knee
Bone-Patellar Tendon-Bone Grafts
Control Groups
Biomechanical Phenomena
Sports
Case-Control Studies
Transplants
Wounds and Injuries
Research

Keywords

  • ACL reconstruction
  • Anatomic tunnel placement
  • Gait analysis
  • Knee rotational instability
  • Landing
  • Pivoting
  • Tibial rotation

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine

Cite this

Excessive tibial rotation during high-demand activities is not restored by anterior cruciate ligament reconstruction. / Ristanis, Stavros; Stergiou, Nicholas; Patras, Kostas; Vasiliadis, Haris S.; Giakas, Giannis; Georgoulis, Anastasios D.

In: Arthroscopy - Journal of Arthroscopic and Related Surgery, Vol. 21, No. 11, 01.11.2005, p. 1323-1329.

Research output: Contribution to journalArticle

Ristanis, Stavros ; Stergiou, Nicholas ; Patras, Kostas ; Vasiliadis, Haris S. ; Giakas, Giannis ; Georgoulis, Anastasios D. / Excessive tibial rotation during high-demand activities is not restored by anterior cruciate ligament reconstruction. In: Arthroscopy - Journal of Arthroscopic and Related Surgery. 2005 ; Vol. 21, No. 11. pp. 1323-1329.
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AU - Ristanis, Stavros

AU - Stergiou, Nicholas

AU - Patras, Kostas

AU - Vasiliadis, Haris S.

AU - Giakas, Giannis

AU - Georgoulis, Anastasios D.

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N2 - Purpose: Recent in vitro research has suggested that anterior cruciate ligament (ACL) reconstruction does not restore control of tibial rotation. The purpose of this study was to explore these findings in vivo and investigate rotational knee stability during landing and subsequent pivoting. Such an activity places higher demands on the knee, almost similar to those found during high-level sports. Type of Study: Case control series study. Methods: We assessed 11 patients who had undergone ACL reconstruction with the same arthroscopic technique using a bone-patellar tendon-bone graft, 11 ACL-deficient subjects who had sustained the injury more than 1 year prior to testing, and 11 matched controls. Kinematic data were collected (50 Hz) with a 6-camera optoelectronic system while the subjects performed the following task: they jumped off a 40-cm platform and landed on the ground. After foot contact, the subjects were instructed to pivot at 90°and walk away from the platform. The evaluation period was identified from initial foot contact with the ground with both legs, included the pivoting of the ipsilateral leg, and was completed on touchdown of the contralateral leg. Results: Significant differences were found between the reconstructed leg of the ACL group and the healthy control, and between the deficient leg of the ACL-deficient group and the healthy control. We also found no significant differences between the deficient leg of the ACL-deficient group and the reconstructed leg of the ACL reconstructed group. Conclusions: It was concluded that, under high-stress activities, ACL reconstruction may not restore tibial rotation to the previous physiological level, even though anterior tibial translation is restored. Future research on ACL reconstruction should focus on the development of new surgical procedures and/or grafts to address this problem. Level of Evidence: Level III.

AB - Purpose: Recent in vitro research has suggested that anterior cruciate ligament (ACL) reconstruction does not restore control of tibial rotation. The purpose of this study was to explore these findings in vivo and investigate rotational knee stability during landing and subsequent pivoting. Such an activity places higher demands on the knee, almost similar to those found during high-level sports. Type of Study: Case control series study. Methods: We assessed 11 patients who had undergone ACL reconstruction with the same arthroscopic technique using a bone-patellar tendon-bone graft, 11 ACL-deficient subjects who had sustained the injury more than 1 year prior to testing, and 11 matched controls. Kinematic data were collected (50 Hz) with a 6-camera optoelectronic system while the subjects performed the following task: they jumped off a 40-cm platform and landed on the ground. After foot contact, the subjects were instructed to pivot at 90°and walk away from the platform. The evaluation period was identified from initial foot contact with the ground with both legs, included the pivoting of the ipsilateral leg, and was completed on touchdown of the contralateral leg. Results: Significant differences were found between the reconstructed leg of the ACL group and the healthy control, and between the deficient leg of the ACL-deficient group and the healthy control. We also found no significant differences between the deficient leg of the ACL-deficient group and the reconstructed leg of the ACL reconstructed group. Conclusions: It was concluded that, under high-stress activities, ACL reconstruction may not restore tibial rotation to the previous physiological level, even though anterior tibial translation is restored. Future research on ACL reconstruction should focus on the development of new surgical procedures and/or grafts to address this problem. Level of Evidence: Level III.

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KW - Anatomic tunnel placement

KW - Gait analysis

KW - Knee rotational instability

KW - Landing

KW - Pivoting

KW - Tibial rotation

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