Anterior Cruciate Ligament Analysis

Proprioception essentially means being able to tell where one is in space. This may seem like an easy thing, especially since it is usually not something a person thinks about; however, after an injury, proprioception becomes rather difficult. In order to completely recover from the injury and safely return to play or normal daily activities, the person must work on regaining proprioception in their injured limb as well as the whole body.

The authors of the study compared the proprioception of 20 male patients pre- and post-operative anterior cruciate ligament (ACL) reconstruction with 16 male volunteers around the same age who were healthy. All 20 patients had the same doctor perform their surgery. The surgeon used the same type of graph for all patients. Knee proprioception was measured before surgery and then again 6 months after. The reconstruction patients all endured the same rehabilitation program. The program incorporated mostly proprioception exercises especially toward the last few months. These included single leg balance, drawing a figure eight with the foot, wobble-board, and trampoline exercises. The authors measured joint position sense at various knee angles using an isokinetic dynamometer. The subjects’ goal was to duplicate the angle at which the authors

set them during passive motion (30 and 70 degrees). This was repeated every 5 minutes. The average was figured from the attempts and the absolute error was recorded.
Originally, there was only a slight difference between the uninjured leg and the control group during the proprioception knee test.

However, there was a considerable difference with the injured leg compared to the contralateral leg and the control group. After the reconstruction and 6 months of rehab, the joint sense in the injured leg greatly improved and only shown a small difference when compared to the uninjured leg and the control group. Overall, the authors found it important to incorporate proprioception exercises into the rehab program for an ACL reconstruction surgery. Doing these exercises can enhance the overall stability of the leg as well as positively impact the functional

status.
This article was fairly interesting, especially the differences between the injured and uninjured legs at the start of the study and then again at the end. Knowing people who have experienced several knee surgeries including an ACL reconstruction, balancing on a post-operative leg can be rather difficult. Some of this may be due to an atrophied quadriceps muscle after surgery. However, the difference before operation is rather interesting. Could the slight difference between the uninjured leg and the control group be a factor in why the patient torn their ACL or does the decreased proprioception in the uninjured leg correspond to the major difference with the injured leg. Maybe this is obvious, but it’s not crazy to at least consider the possibility that the greater the proprioception deficit in a person’s leg the more likely they will be to damage the leg and even potentially tear an ACL. The results of the study prove how important proprioception and balance are in the rehab process. It would be important to determine the opportune time of when to start proprioception exercises during rehab. Maybe the sooner a patient can begin these exercises the sooner they will be able to return to functional activity and then eventually full play again.