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. 2022 Jun 13;10(6):23259671221098989.
doi: 10.1177/23259671221098989. eCollection 2022 Jun.

Changes in Dynamic Postural Stability After ACL Reconstruction: Results Over 2 Years of Follow-up

Robert H Brophy  1   2 , Kevin A Schafer  1 , Derrick M Knapik  1   2 , John Motley  3 , Amanda Haas  2 , Matthew J Matava  1   2 , Rick W Wright  1   4 , Matthew V Smith  1   2
Affiliations

Changes in Dynamic Postural Stability After ACL Reconstruction: Results Over 2 Years of Follow-up

Robert H Brophy et al. Orthop J Sports Med. .

Abstract

Background: The anterior cruciate ligament (ACL) is crucial for knee proprioception and postural stability. While ACL reconstruction (ACLR) and rehabilitation improve postural stability, the timing in improvement of dynamic postural stability after ACLR remains relatively unknown.

Purpose: To evaluate changes in dynamic postural stability after ACLR out to 24 months postoperatively.

Study design: Case series; Level of evidence, 4.

Methods: Patients undergoing ACLR were prospectively enrolled, and dynamic postural stability was assessed within 2 days before surgery, at 3-month intervals postoperatively to 18 months, then at 24 months. Measurements were made on a multidirectional platform tracking the patient's center of mass based on pelvic motion. The amount of time the patient was able to stay on the platform was recorded, and a dynamic motion analysis score, reflecting the patient's ability to maintain one's center of mass, was generated overall and in 6 independent planes of motion.

Results: A total of 44 patients with a mean age of 19.7 ± 6.2 years completed the study protocol. Overall mean dynamic postural stability improved significantly at 3, 6, 9, and 12 months after surgery, with continued improvement out to 24 months. Notable improvements occurred in medial/lateral and anterior/posterior stability from baseline to 6 months postoperatively, while internal/external rotation and flexion/extension stability declined initially after surgery from baseline to 3 months postoperatively before stabilizing to the end of the study period.

Conclusion: Overall dynamic postural stability significantly improved up to 12 months after ACLR. Improvement in postural stability occurred primarily in the medial/lateral and anterior/posterior planes of motion, with initial decreases in the flexion/extension and internal/external rotational planes of motion.

Keywords: ACL reconstruction; postural stability; proprioception.

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Conflict of interest statement

One or more of the authors has declared the following potential conflict of interest or source of funding: R.H.B. has received education payments from Arthrex, Breg, Elite Orthopedics, and Smith & Nephew; consulting fees from Sanofi; and speaking fees from Arthrex. K.A.S. has received education payments from Elite Orthopedics. D.M.K. has received grant support from Arthrex and education payments from DJO, Elite Orthopedics, Medwest, and Smith & Nephew. M.J.M. has received education payments from Arthrex and Elite Orthopedics/Apollo Orthopedics and consulting fees from Heron Therapeutics and Pacira Pharmaceuticals. R.W.W. has received royalties from Responsive Arthroscopy. M.V.S. has received consulting fees from Arthrex and Flexion Therapeutics and speaking fees from Elite Orthopedics. AOSSM checks author disclosures against the Open Payments Database (OPD). AOSSM has not conducted an independent investigation on the OPD and disclaims any liability or responsibility relating thereto.

Figures

Figure 1.
Figure 1.
User undergoing dynamic postural stability testing. The multidirectional platform moves in random directions. The patient’s response to these stimuli is tracked using a wearable sensor, measuring the user’s center of motion in 6 planes.
Figure 2.
Figure 2.
Overall dynamic postural stability based on dynamic motion analysis score over 24 months. Error bars represent SD. *Statistically significant improvement compared with prior dynamic motion analysis (DMA) score/time trial. ACL, anterior cruciate ligament.
Figure 3.
Figure 3.
Plane-specific dynamic stability up to 24 months postoperatively in the translational planes. Error bars represent SD. *Statistically significant improvement compared with prior dynamic motion analysis (DMA) score/time trial.
Figure 4.
Figure 4.
Plane-specific dynamic stability up to 24 months postoperatively in the rotational planes. Error bars represent SD. *Statistically significant improvement compared with prior dynamic motion analysis (DMA) score/time trial.
See this image and copyright information in PMC

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