Risk factors for restricted motion after anterior cruciate reconstruction

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Biomechanical Research

Background:

• Anterior cruciate ligament (ACL) reconstruction is a common orthopedic procedure.
• Restricted postoperative range of motion (ROM) can negatively impact patient outcomes.
• Identifying risk factors for limited ROM is crucial for optimizing surgical protocols.

Purpose of the Study:

• To identify factors associated with restricted postoperative motion following ACL reconstruction.
• To evaluate the impact of surgical timing and technique on final ROM.
• To provide evidence-based recommendations for improving patient outcomes.

Main Methods:

• Retrospective review of 373 patients undergoing ACL reconstruction using the central third of the patellar tendon.
• Stepwise logistic regression analysis to identify risk factors for restricted ROM (flexion ≤ 125° or contracture ≥ 10°).
• Subgroup analysis of patients undergoing arthroscopic reconstruction more than 7 days post-injury.

Main Results:

• Open surgery and reconstruction within 7 days of injury were significant predictors of restricted final ROM (P = .0008 and P = .004, respectively).
• Age, meniscal repair, and collateral ligament injuries did not significantly impact ROM.
• Arthroscopic reconstruction >7 days post-injury with early ROM exercises (within 2 days) showed significantly less limited motion (P = .008).

Conclusions:

• Delayed, arthroscopic ACL reconstruction is associated with a lower risk of postoperative motion limitations.
• Early initiation of ROM exercises is a key factor in preventing restricted motion.
• These findings support optimizing surgical timing and rehabilitation protocols to improve functional recovery after ACL reconstruction.