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Between-Limb Symmetry in ACL and Tibiofemoral Contact Forces in Athletes After ACL Reconstruction and Clearance for Return to Sport

BACKGROUND: Current return-to-sport (RTS) criteria after anterior cruciate ligament (ACL) reconstruction (ACLR) include demonstrating symmetry in functional and strength tests. It remains unknown if at the time that athletes are cleared to RTS, they exhibit between-limb symmetry in ACL and tibiofemo...

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Autores principales: Kotsifaki, Argyro, Van Rossom, Sam, Whiteley, Rod, Korakakis, Vasileios, Bahr, Roald, D’Hooghe, Pieter, Papakostas, Emmanuel, Sideris, Vasileios, Farooq, Abdulaziz, Jonkers, Ilse
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9006381/
https://www.ncbi.nlm.nih.gov/pubmed/35434169
http://dx.doi.org/10.1177/23259671221084742
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author Kotsifaki, Argyro
Van Rossom, Sam
Whiteley, Rod
Korakakis, Vasileios
Bahr, Roald
D’Hooghe, Pieter
Papakostas, Emmanuel
Sideris, Vasileios
Farooq, Abdulaziz
Jonkers, Ilse
author_facet Kotsifaki, Argyro
Van Rossom, Sam
Whiteley, Rod
Korakakis, Vasileios
Bahr, Roald
D’Hooghe, Pieter
Papakostas, Emmanuel
Sideris, Vasileios
Farooq, Abdulaziz
Jonkers, Ilse
author_sort Kotsifaki, Argyro
collection PubMed
description BACKGROUND: Current return-to-sport (RTS) criteria after anterior cruciate ligament (ACL) reconstruction (ACLR) include demonstrating symmetry in functional and strength tests. It remains unknown if at the time that athletes are cleared to RTS, they exhibit between-limb symmetry in ACL and tibiofemoral contact forces or if these forces are comparable with those in uninjured athletes. PURPOSES: To (1) examine ACL and tibiofemoral contact forces in athletes who underwent ACLR and were cleared to RTS and (2) compare the involved leg to the healthy contralateral leg and healthy controls during functional tasks. STUDY DESIGN: Cross-sectional study; Level of evidence, 3. METHODS: A total of 26 male athletes who underwent ACLR were tested at the time of RTS during tasks that included single-leg vertical, horizontal, and side jumps; cutting maneuvers; and high-intensity running. We used an electromyography-constrained musculoskeletal modeling workflow to estimate ACL and tibiofemoral contact forces and compared the results with those of 23 healthy male participants. RESULTS: The ACLR group presented no differences in peak tibiofemoral contact forces in the involved limb compared with the control group. However, there were significant between-limb differences mainly due to higher contact forces in the uninvolved (healthy) limb of the ACLR group compared with the control group. In the ACLR group, ACL forces were significantly higher in the uninvolved limb compared with the involved limb during cutting and running. Lateral contact forces were lower in the involved compared with the uninvolved limb, with large effect sizes during cutting (d = 1.14; P < .001) and running (d = 1.10; P < .001). CONCLUSION: Current discharge criteria for clearance to RTS after ACLR did not ensure the restoration of symmetric loading in our cohort of male athletes. ACL force asymmetry was observed during cutting and running, in addition to knee loading asymmetries on several tasks tested.
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spelling pubmed-90063812022-04-14 Between-Limb Symmetry in ACL and Tibiofemoral Contact Forces in Athletes After ACL Reconstruction and Clearance for Return to Sport Kotsifaki, Argyro Van Rossom, Sam Whiteley, Rod Korakakis, Vasileios Bahr, Roald D’Hooghe, Pieter Papakostas, Emmanuel Sideris, Vasileios Farooq, Abdulaziz Jonkers, Ilse Orthop J Sports Med Article BACKGROUND: Current return-to-sport (RTS) criteria after anterior cruciate ligament (ACL) reconstruction (ACLR) include demonstrating symmetry in functional and strength tests. It remains unknown if at the time that athletes are cleared to RTS, they exhibit between-limb symmetry in ACL and tibiofemoral contact forces or if these forces are comparable with those in uninjured athletes. PURPOSES: To (1) examine ACL and tibiofemoral contact forces in athletes who underwent ACLR and were cleared to RTS and (2) compare the involved leg to the healthy contralateral leg and healthy controls during functional tasks. STUDY DESIGN: Cross-sectional study; Level of evidence, 3. METHODS: A total of 26 male athletes who underwent ACLR were tested at the time of RTS during tasks that included single-leg vertical, horizontal, and side jumps; cutting maneuvers; and high-intensity running. We used an electromyography-constrained musculoskeletal modeling workflow to estimate ACL and tibiofemoral contact forces and compared the results with those of 23 healthy male participants. RESULTS: The ACLR group presented no differences in peak tibiofemoral contact forces in the involved limb compared with the control group. However, there were significant between-limb differences mainly due to higher contact forces in the uninvolved (healthy) limb of the ACLR group compared with the control group. In the ACLR group, ACL forces were significantly higher in the uninvolved limb compared with the involved limb during cutting and running. Lateral contact forces were lower in the involved compared with the uninvolved limb, with large effect sizes during cutting (d = 1.14; P < .001) and running (d = 1.10; P < .001). CONCLUSION: Current discharge criteria for clearance to RTS after ACLR did not ensure the restoration of symmetric loading in our cohort of male athletes. ACL force asymmetry was observed during cutting and running, in addition to knee loading asymmetries on several tasks tested. SAGE Publications 2022-04-11 /pmc/articles/PMC9006381/ /pubmed/35434169 http://dx.doi.org/10.1177/23259671221084742 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by-nc-nd/4.0/This article is distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 License (https://creativecommons.org/licenses/by-nc-nd/4.0/) which permits non-commercial use, reproduction and distribution of the work as published without adaptation or alteration, without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Article
Kotsifaki, Argyro
Van Rossom, Sam
Whiteley, Rod
Korakakis, Vasileios
Bahr, Roald
D’Hooghe, Pieter
Papakostas, Emmanuel
Sideris, Vasileios
Farooq, Abdulaziz
Jonkers, Ilse
Between-Limb Symmetry in ACL and Tibiofemoral Contact Forces in Athletes After ACL Reconstruction and Clearance for Return to Sport
title Between-Limb Symmetry in ACL and Tibiofemoral Contact Forces in Athletes After ACL Reconstruction and Clearance for Return to Sport
title_full Between-Limb Symmetry in ACL and Tibiofemoral Contact Forces in Athletes After ACL Reconstruction and Clearance for Return to Sport
title_fullStr Between-Limb Symmetry in ACL and Tibiofemoral Contact Forces in Athletes After ACL Reconstruction and Clearance for Return to Sport
title_full_unstemmed Between-Limb Symmetry in ACL and Tibiofemoral Contact Forces in Athletes After ACL Reconstruction and Clearance for Return to Sport
title_short Between-Limb Symmetry in ACL and Tibiofemoral Contact Forces in Athletes After ACL Reconstruction and Clearance for Return to Sport
title_sort between-limb symmetry in acl and tibiofemoral contact forces in athletes after acl reconstruction and clearance for return to sport
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9006381/
https://www.ncbi.nlm.nih.gov/pubmed/35434169
http://dx.doi.org/10.1177/23259671221084742
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