2015 ISAKOS Biennial Congress ePoster #1343

Rehabilitation and Functional Evaluation Following Anatomical Anterior Cruciate Ligament Reconstruction

Ellen Felix, Mauá, SP BRAZIL
Tiago Lazzaretti Fernandes, MD, PhD, MSc, Post-Doctorate, São Paulo, SP BRAZIL
Natália Mariana Luna, MD, Sao Paulo, SP BRAZIL
Daniele Tatiane Dos Santos Lizier, Msc, Sao Paulo, SP BRAZIL
Julia M. D. Greve, MD, PhD, São Paulo, SP BRAZIL
Arnaldo J. Hernandez, MD, PhD, São Paulo, SP BRAZIL
University of Sao Paulo, Sao Paulo, SP, BRAZIL

FDA Status Not Applicable

Summary: There are a trend toward that postural control was not fully recovered following Anterior cruciate ligament reconstruction

Abstract:

Anterior cruciate ligament (ACL) injury causes instability and changes in the proprioceptive afferent with loss of postural control. Anatomical reconstruction is a well-established treatment that restores mechanical stability of the knee as well as it achieves higher functional results. However, there appears to be a trend towards impaired postural control in athletes underwent ACL reconstruction when compared to controls. Dynamic balance task may be more relevant to sport context and challenging to the postural control. Although there being a growing literature involving the recovery of postural control following ACL reconstruction surgery, the extent to which postural control is restored and its mechanism of restoration following surgery are not yet fully known. At our Sports Medicine Group of University of São Paulo Medical School and FIFA Medical Centre of excellence, the postoperative rehabilitation using hamstring graft is divided into 5 phases: Immediate, early, intermediate, late and return to competition, with specific goals as determinants for phase progression. Emphasis is placed on early range of motion, preservation of quadriceps function, progression of activities and not exceeding the limits of the involved tissue healing properties. At our group, athletes undergone ACL reconstruction have been evaluated not only by hop-test, isokinetic dynamometry, questionnaires such as subjective IKDC and Lysholm, but also posturography. Besides, the latter has been applied but is not the routine for all patients. The posturography evaluation is carried out by four tests in single leg stance, and each test is done three times. The tests in the eyes opened and the eyes closed conditions last 30 seconds, and others last 10 seconds each. The variables obtained in sagittal and frontal plane are velocity and Area 95 (95% of the ellipse given by the trajectory of the Center of pressure area) of displacement. Quadriceps and hamstring isokinetic strength were assessed at velocities of 60°/s and 240°/s with the dynamometer before, 6 and 12 months after ACL reconstruction. Although the ACL injury is widely studied, future researches with different techniques of quantitative assessments are still needed.