Hamstring 7
Hamstring 7
Hamstring 7
ORIGINAL ARTICLE
INFLUENCE OF ANTERIOR CRUCIATE LIGAMENT SURGERY WITH
IJPHY
SEMITENDINOUS AND GRACILIS GRAFT ON STATIC POSTURAL BALANCE
AT 3 MONTHS POSTOPERATIVELY: RANDOMIZED CONTROLLED STUDY
1
Marc Linard
¹Jean Mazeas
1, 2
Maude Traulle
³Amaury Vandebrouck
³Pascal Duffiet
³Louis Ratte
*1,2
Florian Forelli
ABSTRACT
Background: The anterior cruciate ligament (ACL) tear is the most common sports injury. Surgery is often proposed,
but single-leg and double-leg static postural disorders have been discovered several months after surgery. Our aims
are to compare postural disorders after ligament reconstruction by hamstring tendon graft in the three months after
surgery to those caused by aging.
Methods: 2 groups of subjects underwent bilateral and unilateral postural tests. An analysis of the center of pressure’s
displacement is carried out for each test.
Results: Comparison of the two groups shows no significant difference for the injured leg on the unilateral and bilateral
tests only (p-value>0,05).
Conclusion: Postural alteration after an ACL reconstruction on the injured leg and bilateral posture can be compared
to postural disorders caused by age.
Keywords: Anterior cruciate ligament, Stabilometry, Force Plateform, Postural balance.
Received 05th October 2019, accepted 28th November 2019, published 09th December 2019
10.15621/ijphy/2019/v6i6/190222
www.ijphy.org
CORRESPONDING AUTHOR
*1
Florian FORELLI
¹Researcher Physical Therapist in OrthoLab,
Clinic of Domont, France. Researcher Physical Therapist and Co-Director
²Co-director OrthoLab, Clinic of Domont, France. OrthoLab, 85 route de Domont, 95330 Domont,
³Knee Orthopaedic Surgeon, Clinic of Domont, France.
France. Email: fforelli@capio.fr
This article is licensed under a Creative Commons Attribution-Non Commercial 4.0 International License.
Copyright © 2019 Author(s) retain the copyright of this article.
participants in the study is less than 15 in the test and AV= average ; SD= Standard Deviation; *= significant difference (ρ-value<0,05)
control group, it is accepted that the values obtained do not
follow a normal distribution. Mann-Whitney tests were DISCUSSION
performed to allow comparison of the results obtained. Static postural balance and its study tend to develop today
RESULTS with the appearance and improvement of new tools such as
force platforms. The purpose of the study was to compare
The age and test groups did not show a statistically significant the postural alteration present after ACL surgery with
difference for the height, weight, body mass index, and STG at three months postoperatively to that caused by
sex variables (p-value> 0.05). For the age variable, both physiological aging. The objective of this study is, therefore,
groups have a statistically significant difference (p-value not to evaluate the quality of the ACL surgery with STG
<0.05). An absence of a statistically significant difference on the postural parameter but to allow the reeducators to
(p-value> 0.05) is found between the two populations for acquire information on the possible postural imbalances
all the variables studied when during the bipodal tests. present after surgery and to be able to compare them with
A statistically significant absence of difference (p-value> another population also presenting balance disorders.
0.05) is found when comparing the two lower limbs in the
control population. Randomly, it was decided to compare This study used a customized support base compared to
unipodal support on the injured side to the unipodal right selected studies that use a standardized support base. In
support of the elderly group and to compare the unipodal their study, Mouzat et al. (2005) [28] demonstrated that the
support on the healthy side of the ACL group to the left increase in the spacing of the opening angle of the feet is
unipodal support of the elderly group. correlated with an improvement of the static equilibrium.
The use of a personalized support base is therefore sensible
Table 1: Characteristics of the test and control groups to allow subjects to place themselves in a position where
(mean ± standard deviation) they feel stable rather than constrain them in a potentially
Test Group Control Group unbalanced position. The results obtained will focus more
ρ-value
(n = 7) (n = 11) precisely on the personal and functional characteristics of
Age (y) 36,8±11,8 62,4±8,2 0,005 each individual.
Height (m) 1,79±0,10 1,68±0,08 0,08 This study is the only one to compare the postural balance
Weight (kg) 79,7±18,1 67,2±6,4 0,08
after ACL surgery with STG to a healthy and elderly
population.
Body Mass Index 24,7±3,5 23,8±1,6 0,79
Numerous studies have investigated the quantification of
Sex (M/F) 6/1 3/8 0,08
postural disorders following ACL surgery compared to
Operated knee (R/L) 4/3 Ø /
an asymptomatic population. The results are not identical
M/F= male/female ; R/L = right/left ; y=years ; m= metre ; kg=kilogramme ; because of the difference in the postoperative time of the
Ø= no ACL surgery; /= value not calculated
subjects included.
Statistical analysis revealed a statistically significant Dauty et al. (2010) [12] studied postural disorders after ACL
difference (p-value> 0.05) for all the variables studied reconstruction, 15 days postoperatively. The results of the
when comparing unipodal support on the injured side bipodal tests, knees extended or flexed, show a significant
of the ACL group and the right side of the elderly group. increase in the displacement of the center of pressure in
Significant p-values (p-value
<0.05) are found for the the group has benefited from an ACL surgery compared
variables Xamp, Yamp, and Area 95 during the comparison to the control group. In unipodal opened eyes and knee
between the healthy side of the ACL group and the left side extension, the study revealed a significant difference in
of the old group. Area95 measurement and complete COP displacement
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