Skip to main content
SpringerLink
Log in

Is postural control restored following anterior cruciate ligament reconstruction? A systematic review

  • Knee
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

The aim of this systematic review was to determine whether lower limb postural control is restored in patients following anterior cruciate ligament (ACL) reconstruction surgery when compared to healthy controls.

Methods

A systematic review was conducted. Electronic databases including Medline, Embase, SPORTDiscus and CINAHL were searched from the earliest possible entry to April 2010. Studies that evaluated postural control in patients following ACL reconstruction surgery with a control group using a force platform were included.

Results

Ten studies evaluating 644 participants at a mean 29 months follow-up were included in this review. In static balance tasks, there was a trend towards improved postural control in the control group for eyes-open but not eyes-closed conditions. Only four studies evaluated dynamic balance, and the results from these were somewhat mixed. Nonetheless, there was evidence to suggest impaired postural control in patients following ACL reconstruction surgery when compared to controls, particularly for more challenging tasks.

Conclusion

Although there appears to be a trend towards impaired static and dynamic postural control in patients following ACL reconstruction surgery, the limited number of studies and differing methodologies makes conclusions tentative. Deficits in dynamic tasks may be more relevant to people intending to return to sport following surgery due to the inherently dynamic nature of sport and should perhaps be the focus of future research.

Level of evidence

III.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Ageberg E, Roberts D, Holmström E, Fridén T (2005) Balance in single-limb stance in patients with anterior cruciate ligament injury. Am J Sports Med 33:1527–1535

    Article  PubMed  Google Scholar 

  2. Ageberg E, Zatterstrom R, Friden T, Moritz U (2001) Individual factors affecting stabilometry and one-leg hop test in 75 healthy subjects, aged 15–44 years. Scand J Med Sci Sports 11:47–53

    Article  PubMed  CAS  Google Scholar 

  3. Alonso A, Greve J, Camanho G (2009) Evaluating the center of gravity of dislocations in soccer players with and without reconstruction of the anterior cruciate ligament using a balance platform. Clinics (Sao Paulo) 64:163–170

    Google Scholar 

  4. Ardern C, Webster K, Taylor N, Feller J (2010) Return to sport following anterior cruciate ligament reconstruction surgery: A systematic review and meta-analysis of the state of play. Br J Sports Med. doi:10.1136/bjsm.2010.076364

  5. Barrack R, Lund P, Munn BCW, Happel L (1997) Evidence of reinnervation of free patellar tendon autograft used for anterior cruciate ligament reconstruction. Am J Sports Med 25:196–202

    Article  PubMed  CAS  Google Scholar 

  6. Birmingham T, Kramer J, Kirkley A, Inglis T, Spaulding S, Vandervoort A (2001) Knee bracing after ACL reconstruction: Effects on postural control and proprioception. Med Sci Sports Exerc 33:1253–1258

    Article  PubMed  CAS  Google Scholar 

  7. Bonfim TR, Paccola CA, Barela JA (2003) Proprioceptive and behavior impairments in individuals with anterior cruciate ligament reconstructed knees. Arch Phys Med Rehabil 84:1217–1223

    Article  PubMed  Google Scholar 

  8. Brunetti O, Filippi G, Lorenzini M, Liti A, Panichi R, Roscini M, Pettorossi V, Cerulli G (2006) Improvement of posture stability by vibratory stimulation following anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc 14:1180–1187

    Article  PubMed  CAS  Google Scholar 

  9. Chmielewski TL, Wilk KE, Snyder-Mackler L (2002) Changes in weight-bearing following injury or surgical reconstruction of the ACL: Relationship to quadriceps strength and function. Gait Posture 16:87–95

    Article  PubMed  Google Scholar 

  10. Clark R, Bryant A, Pua Y, McCrory P, Bennell K, Hunt M (2010) Validity and reliability of the Nintendo Wii Balance Board for assessment of standing balance. Gait Posture 31:307–310

    Article  PubMed  Google Scholar 

  11. Cohen J (1988) Statistical power analysis for the behavioural sciences, 2nd edn. Erlbaum Hillsdale, New Jersey

    Google Scholar 

  12. Denti M, Randelli P, Lo Vetere D, Moioli M, Bagnoli I, Cawley PW (2000) Motor control performance in the lower extremity: normals vs. anterior cruciate ligament reconstructed knees 5–8 years from the index surgery. Knee Surg Sports Traumatol Arthrosc 8:296–300

    Article  PubMed  CAS  Google Scholar 

  13. Downs S, Black N (1998) The feasibility of creating a checklist for the assessment of the methodological quality of health care interventions. J Epidemiol Community Health 52:377–384

    Article  PubMed  CAS  Google Scholar 

  14. Faul F, Erdfelder E, Lang A, Buchner A (2007) G*Power 3: A flexible statistical power analysis program for the social. behavioral and biomedical sciences Behav Res Methods 39:175–191

    Google Scholar 

  15. Fridén T, Zatterstrom R, Lindstrand A, Moritz U (1990) Disability in anterior cruciate ligament insufficiency. An analysis of 19 untreated patients. Acta Orthop Scand 61:131–135

    Article  PubMed  Google Scholar 

  16. Gauffin H, Pettersson G, Tegner Y, Tropp H (1990) Function testing in patients with old rupture of the anterior cruciate ligament. Int J Sports Med 11:73–77

    Article  PubMed  CAS  Google Scholar 

  17. Harrison EL, Duenkel N, Dunlop R, Russell G (1994) Evaluation of single-leg standing following anterior cruciate ligament surgery and rehabilitation. Phys Ther 74:245–252

    PubMed  CAS  Google Scholar 

  18. Heijne A, Werner S (2007) Early versus late start of open kinetic chain quadriceps exercises after ACL reconstruction with patellar tendon or hamstring grafts: A prospective randomized outcome study. Knee Surg Sports Traumatol Arthrosc 15:402–414

    Article  PubMed  Google Scholar 

  19. Henriksson M, Ledin T, Good L (2001) Postural control after anterior cruciate ligament reconstruction and functional rehabilitation. Am J Sports Med 29:359–366

    PubMed  CAS  Google Scholar 

  20. Hoffman M, Schrader J, Koceja D (1999) An investigation of postural control in postoperative anterior cruciate ligament reconstruction patients. J Athl Train 34:130–136

    PubMed  CAS  Google Scholar 

  21. Johansson H, Sjolander P, Sojka P (1991) A sensory role for the cruciate ligaments. Clin Orthop 268:161–178

    PubMed  Google Scholar 

  22. Kuster M, Grob K, Kuster M, Wood G, Gachter A (1999) The benefits of wearing a compression sleeve after ACL reconstruction. Med Sci Sports Exerc 31:368–371

    Article  PubMed  CAS  Google Scholar 

  23. MacDonald P, Hedden D, Pacin O, Sutherland K (1996) Proprioception in anterior cruciate ligament-deficient and reconstructed knees. Am J Sports Med 24:774–778

    Article  PubMed  CAS  Google Scholar 

  24. Mattacola CG, Perrin DH, Gansneder BM, Gieck JH, Saliba EN, McCue FC (2002) Strength, functional outcome, and postural stability after anterior cruciate ligament reconstruction. J Athl Train 37:262–268

    PubMed  Google Scholar 

  25. Merlin T, Weston A, Tooher R (2009) Extending an evidence hierarchy to include topics other than treatment: Revising the Australian ‘levels of evidence’. BMC Med Res Methodol 9:34

    Article  PubMed  Google Scholar 

  26. Moezy A, Olyaei G, Hadian M, Razi M, Faghihzadeh S (2008) A comparative study of whole body vibration training and conventional training on knee proprioception and postural stability after anterior cruciate ligament reconstruction. Br J Sports Med 42:373–378

    Article  PubMed  CAS  Google Scholar 

  27. Negahban H, Hadian MR, Salavati M, Mazaheri M, Talebian S, Jafari AH, Parnianpour M (2009) The effects of dual-tasking on postural control in people with unilateral anterior cruciate ligament injury. Gait Posture 30:477–481

    Article  PubMed  Google Scholar 

  28. Nordahl S, Aasen T, Dyrkorn B, Eidsvik S, Molvaer O (2000) Static stabilometry and repeated testing in a normal population. Aviat Space Environ Med 71:889–893

    PubMed  CAS  Google Scholar 

  29. Risberg M, Holm I, Myklebust G, Engebretsen L (2007) Neuromuscular training versus strength training during first 6 months after anterior cruciate ligament reconstruction: A randomized clinical trial. Phys Ther 87:737–750

    Article  PubMed  Google Scholar 

  30. Salavati M, Hadian M, Mazaheri M, Negahban H, Ebrahimi I, Talebian S, Jafari A, Sanjari M, Sohani S, Parnianpour M (2009) Test-retest reliability of center of pressure measures of postural stability during quiet standing in a group with musculoskeletal disorders consisting of low back pain, anterior cruciate ligament injury and functional ankle instability. Gait Posture 29:460–464

    Article  PubMed  Google Scholar 

  31. Shiraishi M, Mizuta H, Kubota K, Otsuka Y, Nagamoto N, Takagi K (1996) Stabilometric assessment in the anterior cruciate ligament-reconstructed knee. Clin J Sport Med 6:32–39

    Article  PubMed  CAS  Google Scholar 

  32. Trulsson A, Roos E, Ageberg E, Garwicz M (2010) Relationships between postural orientation and self reported function, hop performance and muscle power in subjects with anterior cruciate ligament injury. BMC Musculoskelet Disord 11:143

    Article  PubMed  Google Scholar 

  33. Vathrakokilis K, Malliou P, Gioftsidou A, Beneka A, Godolias G (2008) Effects of a balance training protocol on knee joint proprioception after anterior cruciate ligament reconstruction. J Back Musculoskelet Rehabil 21:233–237

    Google Scholar 

  34. Wojtys E, Huston L (2000) Longitudinal effects of anterior cruciate ligament injury and patellar tendon autograft reconstruction on neuromuscular performance. Am J Sports Med 28:336–344

    PubMed  CAS  Google Scholar 

  35. Zouita Ben Moussa A, Zouita S, Dziri C, Ben Salah FZ (2009) Single-leg assessment of postural stability and knee functional outcome 2 years after anterior cruciate ligament reconstruction. Ann Phys Rehabil Med 52:475–484

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Musculoskeletal Research Centre, Faculty of Health Sciences, La Trobe University, Bundoora, VIC, 3086, Australia

    Brooke E. Howells, Clare L. Ardern & Kate E. Webster

Authors
  1. Brooke E. Howells
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Clare L. Ardern
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Kate E. Webster
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Kate E. Webster.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Howells, B.E., Ardern, C.L. & Webster, K.E. Is postural control restored following anterior cruciate ligament reconstruction? A systematic review. Knee Surg Sports Traumatol Arthrosc 19, 1168–1177 (2011). https://doi.org/10.1007/s00167-011-1444-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00167-011-1444-x

Keywords

Search

Navigation