Anterior cruciate ligament reconstruction and return to

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AUTHOR'S PROOF!

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Article Title

Anterior cruciate ligament reconstruction and return to sport activ ity: postural control as the key to success

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Article Sub- Title

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Article Copyright Year

SICOT aisbl 2014 (This w ill be the copyright line in the final PDF)

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Journal Name

International Orthopaedics

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Family Name

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Particle

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Organization

University of Salerno

Division

Department of Musculoskeletal Disorders, Faculty of Medicine and Surgery

Address

Baronissi 84081, Salerno, Italy

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Organization

Mile End Hospital

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Division

Centre for Sports and Exercise Medicine, Barts and The London School of Medicine and Dentistry

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275 Bancroft Road, London E1 4DG, UK

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[email protected]

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Papalia

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Author

Maffulli Nicola

Rocco

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Campus Bio-Medico University of Rome

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Department of Orthopaedic and Trauma Surgery

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Via Alvaro del Portillo 200, Rome, Italy

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Franceschi Francesco Campus Bio-Medico University of Rome

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Department of Orthopaedic and Trauma Surgery

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Via Alvaro del Portillo 200, Rome, Italy

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Author

Tecame Andrea

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Campus Bio-Medico University of Rome

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Department of Orthopaedic and Trauma Surgery

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Via Alvaro del Portillo 200, Rome, Italy

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Author

D’Adamio Stefano

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Campus Bio-Medico University of Rome

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Department of Orthopaedic and Trauma Surgery

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Via Alvaro del Portillo 200, Rome, Italy

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Denaro Vincenzo

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Campus Bio-Medico University of Rome

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Department of Orthopaedic and Trauma Surgery

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Via Alvaro del Portillo 200, Rome, Italy

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Received

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Revised Accepted

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Abstract

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Keywords separated by ' - '

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Foot note information

3 August 2014 14 August 2014

ACL - Reconstruction - Semitendinosus and gracilis - Patellar tendon - Rehabilitation - KAM

AUTHOR'S PROOF!

JrnlID 264_ArtID 2513_Proof# 1 - 03/09/2014

International Orthopaedics (SICOT) DOI 10.1007/s00264-014-2513-9

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Anterior cruciate ligament reconstruction and return to sport activity: postural control as the key to success Rocco Papalia & Francesco Franceschi & Andrea Tecame & Stefano D’Adamio & Nicola Maffulli & Vincenzo Denaro

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Received: 3 August 2014 / Accepted: 14 August 2014 # SICOT aisbl 2014

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Abstract Purpose The risk for re-tear following anterior cruciate ligament (ACL) reconstruction is influenced by several hormonal, neuromuscular, biomechanical and anatomic factors. One of the most important negative prognostic factors that markedly increase the risk for ACL re-tear is the presence of high kneeabduction moment (KAM), which can be measured immediately by landing on both feet after a vertical jump. We evaluated the effect in postoperative values for KAM according to the type of graft used for ACL reconstruction (hamstring vs patellar tendon) and a specific rehabilitation protocol focusing on recovery of muscular strength, proprioception and joint stabilisation. Methods From November 2010 to September 2012, we enrolled 40 female recreational athletes with clinical and imaging evidence of ACL tear and randomised them in two groups. One group of patients underwent reconstruction with a hamstring-tendon graft and the second with a patellar-tendon graft. A custom rehabilitation programme focusing on proprioception was adopted. Clinical outcomes [International Knee Documentation Committee (IKDC) and Lysholm scores] and performance in functional test for stability (single-leg hop,

timed hop, crossover triple hop, KAM test) were assessed preoperatively at 3 and 6 months postoperatively. Results All patients showed statistically significant clinical improvements postoperatively when compared with preoperative values (P