Pre- and postoperative postural regulation following anterior cruciate ligament reconstruction

There are currently no longitudinal data describing the pre- and postoperative postural regulation and stability of patients with anterior cruciate ligament (ACL) damage. Therefore, the aim of this study was to evaluate postural regulation and stability prior to and during rehabilitation following surgery of the ACL. Fifty-four physically active subjects (age: 30.5±10.9 years, 29 male subjects) were examined with the Interactive Balance System pre-, 6, and at 12 weeks following surgical reconstruction 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 (parameter: left) increased significantly (patients with left-sided/right-sided injury: 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 parameters 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 improvements in somatosensory system function, postural stability, weight distribution index, and foot coordination. Also, overloading of the injured side on the feet reduces significantly during rehabilitation. Thus, the initial phase of rehabilitation (weeks 1 to 6) seems to be more effective than the second period (weeks 6 to 12) postoperatively.