Coordination of the Lower Limbs of Soccer Players after Anterior Cruciate Ligament Reconstruction with Allograft and Autograft during Landing

Document Type : RESEARCH PAPER

Authors

1 Iranian Center of Excellence in Physiotherapy, Rehabilitation Research Center, Department of Physiotherapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran

2 2 Iranian Center of Excellence in Physiotherapy, Rehabilitation Research Center, Department of Physiotherapy, and Department of Rehabilitation Management, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran 3Geriatric Mental Health Research Center, Iran University of Medical Sciences, Tehran, Iran

3 Biomechanics Lab., Rehabilitation Research Center, and Department of Basic Rehabilitation Sciences, Faculty of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran

4 Department of Orthopedic, School of Medicine, Iran University of Medical Sciences, Tehran, Iran

Abstract

Objectives: Quantitative biomechanical tests, along with physical assessment, may be useful to
understand kinematics associated with graft types in anterior cruciate ligament surgery, particularly in
individuals aiming for a safe return to sport.
Methods: Sixty male soccer players in three groups participated in this study. Three equal groups of healthy, auto
transplanted and allotransplanted participants, matched for age, gender, activity level and functional status, landed
with one foot on a force plate. Their kinematic information was recorded by the motion analyzer and used to describe
coordination the variability by measuring coupling angles using vector coding.
Results: The coordination variability of the allograft group in the surgical limb was significantly greater than that of
the healthy group at least 9 months after the reconstructive surgery of the ACL and at the stage of return to sports,
(F (6, 35) = 2.79, p = 0.025; Wilk's Λ = 0.676, partial η2 = 0.32). The coordination pattern in the surgical and healthy
limbs of the surgical groups also differed from that of the healthy people, which was more pronounced in the allograft
group, (F (6, 35) = 2.61, p = 0.034; Wilk's Λ = 0.690, partial η2 = 0.31).
Conclusion: These results show that the allograft group has a different coordination variability at return to sport
than the healthy group, so they may need more time for excessive training and competition.
 Level of evidence: II

Keywords

Main Subjects

References

  1. Myrer JW, Schulthies SS, Fellingham GW. Relative and absolute reliability of the KT-2000 arthrometer for uninjured knees. Testing at 67, 89, 134, and 178 N and manual maximum forces. Am J Sports Med. 1996;24(1):104-8. doi: 10.1177/036354659602400119.
  2. Decker LM, Moraiti C, Stergiou N, Georgoulis AD. New insights into anterior cruciate ligament deficiency and reconstruction through the assessment of knee kinematic variability in terms of nonlinear dynamics. Knee Surg Sports Traumatol Arthrosc. 2011;19(10):1620-33. doi: 10.1007/s00167-011-1484-2.
  3. Courtney CA, Rine RM. Central somatosensory changes associated with improved dynamic balance in subjects with anterior cruciate ligament deficiency. Gait Posture. 2006;24(2):190-5. doi: 10.1016/j.gaitpost.2005.08.006.
  4. Kapreli E, Athanasopoulos S, Gliatis J, Papathanasiou M, Peeters R, Strimpakos N, Van Hecke P, Gouliamos A, Sunaert S. Anterior cruciate ligament deficiency causes brain plasticity: a functional MRI study. Am J Sports Med. 2009 Dec;37(12):2419-26. doi: 10.1177/0363546509343201.
  5. Marx RG, Jones EC, Angel M, Wickiewicz TL, Warren RF. Beliefs and attitudes of members of the American Academy of Orthopaedic Surgeons regarding the treatment of anterior cruciate ligament injury. Arthroscopy. 2003;19(7):762-70. doi: 10.1016/s0749-8063(03)00398-0.
  6. Ma Y, Murawski CD, Rahnemai-Azar AA, Maldjian C, Lynch AD, Fu FH. Graft maturity of the reconstructed anterior cruciate ligament 6 months postoperatively: a magnetic resonance imaging evaluation of quadriceps tendon with bone block and hamstring tendon autografts. Knee Surg Sports Traumatol Arthrosc. 2015;23(3):661-8. doi: 10.1007/s00167-014-3302-0.
  7. Saltzman BM, Cvetanovich GL, Nwachukwu BU, Mall NA, Bush-Joseph CA, Bach BR Jr. Economic Analyses in Anterior Cruciate Ligament Reconstruction: A Qualitative and Systematic Review. Am J Sports Med. 2016;44(5):1329-35. doi: 10.1177/0363546515581470.
  8. Breitfuss H, Fröhlich R, Povacz P, Resch H, Wicker A. The tendon defect after anterior cruciate ligament reconstruction using the midthird patellar tendon--a problem for the patellofemoral joint? Knee Surg Sports Traumatol Arthrosc. 1996;3(4):194-8. doi: 10.1007/BF01466615.
  9. Seon JK, Song EK, Park SJ. Osteoarthritis after anterior cruciate ligament reconstruction using a patellar tendon autograft. Int Orthop. 2006;30(2):94-8. doi: 10.1007/s00264-005-0036-0.
  10. Cole DW, Ginn TA, Chen GJ, Smith BP, Curl WW, Martin DF, Poehling GG. Cost comparison of anterior cruciate ligament reconstruction: autograft versus allograft. Arthroscopy. 2005;21(7):786-90. doi: 10.1016/j.arthro.2005.04.102.
  11. Genuario JW, Faucett SC, Boublik M, Schlegel TF. A cost-effectiveness analysis comparing 3 anterior cruciate ligament graft types: bone-patellar tendon-bone autograft, hamstring autograft, and allograft. Am J Sports Med. 2012;40(2):307-14. doi: 10.1177/0363546511426088.
  12. Greis PE, Koch BS, Adams B. Tibialis anterior or posterior allograft anterior cruciate ligament reconstruction versus hamstring autograft reconstruction: an economic analysis in a hospital-based outpatient setting. Arthroscopy. 2012;28(11):1695-701. doi: 10.1016/j.arthro.2012.04.144.
  13. Barrera Oro F, Sikka RS, Wolters B, Graver R, Boyd JL, Nelson B, Swiontkowski MF. Autograft versus allograft: an economic cost comparison of anterior cruciate ligament reconstruction. Arthroscopy. 2011;27(9):1219-25. doi: 10.1016/j.arthro.2011.04.008.
  14. Singhal MC, Gardiner JR, Johnson DL. Failure of primary anterior cruciate ligament surgery using anterior tibialis allograft. Arthroscopy. 2007;23(5):469-75. doi: 10.1016/j.arthro.2006.12.010.
  15. Centers for Disease Control (CDC). Transmission of HIV through bone transplantation: case report and public health recommendations. MMWR Morb Mortal Wkly Rep. 1988 Oct 7;37(39):597-9.
  16. Hu J, Qu J, Xu D, Zhou J, Lu H. Allograft versus autograft for anterior cruciate ligament reconstruction: an up-to-date meta-analysis of prospective studies. Int Orthop. 2013;37(2):311-20. doi: 10.1007/s00264-012-1720-5.

17.Mascarenhas R, Tranovich M, Karpie JC, Irrgang JJ, Fu FH, Harner CD. Patellar tendon anterior cruciate ligament reconstruction in the high-demand patient: evaluation of autograft versus allograft reconstruction. Arthroscopy. 2010;26(9 Suppl):S58-66. doi: 

  1. Myrer JW, Schulthies SS, Fellingham GW. Relative and absolute reliability of the KT-2000 arthrometer for uninjured knees. Testing at 67, 89, 134, and 178 N and manual maximum forces. Am J Sports Med. 1996;24(1):104-8. doi: 10.1177/036354659602400119.
  2. Decker LM, Moraiti C, Stergiou N, Georgoulis AD. New insights into anterior cruciate ligament deficiency and reconstruction through the assessment of knee kinematic variability in terms of nonlinear dynamics. Knee Surg Sports Traumatol Arthrosc. 2011;19(10):1620-33. doi: 10.1007/s00167-011-1484-2.
  3. Courtney CA, Rine RM. Central somatosensory changes associated with improved dynamic balance in subjects with anterior cruciate ligament deficiency. Gait Posture. 2006;24(2):190-5. doi: 10.1016/j.gaitpost.2005.08.006.
  4. Kapreli E, Athanasopoulos S, Gliatis J, Papathanasiou M, Peeters R, Strimpakos N, Van Hecke P, Gouliamos A, Sunaert S. Anterior cruciate ligament deficiency causes brain plasticity: a functional MRI study. Am J Sports Med. 2009 Dec;37(12):2419-26. doi: 10.1177/0363546509343201.
  5. Marx RG, Jones EC, Angel M, Wickiewicz TL, Warren RF. Beliefs and attitudes of members of the American Academy of Orthopaedic Surgeons regarding the treatment of anterior cruciate ligament injury. Arthroscopy. 2003;19(7):762-70. doi: 10.1016/s0749-8063(03)00398-0.
  6. Ma Y, Murawski CD, Rahnemai-Azar AA, Maldjian C, Lynch AD, Fu FH. Graft maturity of the reconstructed anterior cruciate ligament 6 months postoperatively: a magnetic resonance imaging evaluation of quadriceps tendon with bone block and hamstring tendon autografts. Knee Surg Sports Traumatol Arthrosc. 2015;23(3):661-8. doi: 10.1007/s00167-014-3302-0.
  7. Saltzman BM, Cvetanovich GL, Nwachukwu BU, Mall NA, Bush-Joseph CA, Bach BR Jr. Economic Analyses in Anterior Cruciate Ligament Reconstruction: A Qualitative and Systematic Review. Am J Sports Med. 2016;44(5):1329-35. doi: 10.1177/0363546515581470.
  8. Breitfuss H, Fröhlich R, Povacz P, Resch H, Wicker A. The tendon defect after anterior cruciate ligament reconstruction using the midthird patellar tendon--a problem for the patellofemoral joint? Knee Surg Sports Traumatol Arthrosc. 1996;3(4):194-8. doi: 10.1007/BF01466615.
  9. Seon JK, Song EK, Park SJ. Osteoarthritis after anterior cruciate ligament reconstruction using a patellar tendon autograft. Int Orthop. 2006;30(2):94-8. doi: 10.1007/s00264-005-0036-0.
  10. Cole DW, Ginn TA, Chen GJ, Smith BP, Curl WW, Martin DF, Poehling GG. Cost comparison of anterior cruciate ligament reconstruction: autograft versus allograft. Arthroscopy. 2005;21(7):786-90. doi: 10.1016/j.arthro.2005.04.102.
  11. Genuario JW, Faucett SC, Boublik M, Schlegel TF. A cost-effectiveness analysis comparing 3 anterior cruciate ligament graft types: bone-patellar tendon-bone autograft, hamstring autograft, and allograft. Am J Sports Med. 2012;40(2):307-14. doi: 10.1177/0363546511426088.
  12. Greis PE, Koch BS, Adams B. Tibialis anterior or posterior allograft anterior cruciate ligament reconstruction versus hamstring autograft reconstruction: an economic analysis in a hospital-based outpatient setting. Arthroscopy. 2012;28(11):1695-701. doi: 10.1016/j.arthro.2012.04.144.
  13. Barrera Oro F, Sikka RS, Wolters B, Graver R, Boyd JL, Nelson B, Swiontkowski MF. Autograft versus allograft: an economic cost comparison of anterior cruciate ligament reconstruction. Arthroscopy. 2011;27(9):1219-25. doi: 10.1016/j.arthro.2011.04.008.
  14. Singhal MC, Gardiner JR, Johnson DL. Failure of primary anterior cruciate ligament surgery using anterior tibialis allograft. Arthroscopy. 2007;23(5):469-75. doi: 10.1016/j.arthro.2006.12.010.
  15. Centers for Disease Control (CDC). Transmission of HIV through bone transplantation: case report and public health recommendations. MMWR Morb Mortal Wkly Rep. 1988 Oct 7;37(39):597-9.
  16. Hu J, Qu J, Xu D, Zhou J, Lu H. Allograft versus autograft for anterior cruciate ligament reconstruction: an up-to-date meta-analysis of prospective studies. Int Orthop. 2013;37(2):311-20. doi: 10.1007/s00264-012-1720-5.
  17. Mascarenhas R, Tranovich M, Karpie JC, Irrgang JJ, Fu FH, Harner CD. Patellar tendon anterior cruciate ligament reconstruction in the high-demand patient: evaluation of autograft versus allograft reconstruction. Arthroscopy. 2010;26(9 Suppl):S58-66. doi: 10.1016/j.arthro.2010.01.004
  18. Noh JH, Yi SR, Song SJ, Kim SW, Kim W. Comparison between hamstring autograft and free tendon Achilles allograft: minimum 2-year follow-up after anterior cruciate ligament reconstruction using EndoButton and Intrafix. Knee Surg Sports Traumatol Arthrosc. 2011;19(5):816-22. doi: 10.1007/s00167-010-1388-6.
  19. Wiggins AJ, Grandhi RK, Schneider DK, Stanfield D, Webster KE, Myer GD. Risk of Secondary Injury in Younger Athletes After Anterior Cruciate Ligament Reconstruction: A Systematic Review and Meta-analysis. Am J Sports Med. 2016;44(7):1861-76. doi: 10.1177/0363546515621554.
  20. Simon D, Mascarenhas R, Saltzman BM, Rollins M, Bach BR Jr, MacDonald P. The Relationship between Anterior Cruciate Ligament Injury and Osteoarthritis of the Knee. Adv Orthop. 2015;2015:928301. doi: 10.1155/2015/928301.
  21. Kelso J.A.S, Tuller B. A Dynamical Basis of Action Systems. In: Gazzaniga, M.S., Ed., Handbook of Cognition Neuroscience, Plenum, New York, 321-356. 1984 https://doi.org/10.1007/978-1-4899-2177-2_16
  22. Castanharo R, da Luz BS, Bitar AC, D'Elia CO, Castropil W, Duarte M. Males still have limb asymmetries in multijoint movement tasks more than 2 years following anterior cruciate ligament reconstruction. J Orthop Sci. 2011;16(5):531-5. doi: 10.1007/s00776-011-0118-3.
  23. Gokeler A, Hof AL, Arnold MP, Dijkstra PU, Postema K, Otten E. Abnormal landing strategies after ACL reconstruction. Scand J Med Sci Sports. 2010;20(1): e12-9. doi: 10.1111/j.1600-0838.2008.00873.x.
  24. Orishimo KF, Kremenic IJ, Mullaney MJ, McHugh MP, Nicholas SJ. Adaptations in single-leg hop biomechanics following anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc. 2010;18(11):1587-93. doi: 10.1007/s00167-010-1185-2.
  25. Paterno MV, Schmitt LC, Ford KR, Rauh MJ, Myer GD, Huang B, Hewett TE. Biomechanical measures during landing and postural stability predict second anterior cruciate ligament injury after anterior cruciate ligament reconstruction and return to sport. Am J Sports Med. 2010;38(10):1968-78. doi: 10.1177/0363546510376053.
  26. Xergia SA, Pappas E, Zampeli F, Georgiou S, Georgoulis AD. Asymmetries in functional hop tests, lower extremity kinematics, and isokinetic strength persist 6 to 9 months following anterior cruciate ligament reconstruction. J Orthop Sports Phys Ther. 2013;43(3):154-62. doi: 10.2519/jospt.2013.3967.
  27. Davids, K., Bennett, S., Newell, K. M. (Eds.). Movement system variability. Human kinetics. 2006
  28. Mattacola CG, Perrin DH, Gansneder BM, Gieck JH, Saliba EN, McCue FC 3rd. Strength, Functional Outcome, and Postural Stability After Anterior Cruciate Ligament Reconstruction. J Athl Train. 2002;37(3):262-268
  29. Risberg MA, Holm I, Tjomsland O, Ljunggren E, Ekeland A. Prospective study of changes in impairments and disabilities after anterior cruciate ligament reconstruction. J Orthop Sports Phys Ther. 1999;29(7):400-12. doi: 10.2519/jospt.1999.29.7.400.
  30. Turvey MT, Fitch, HL., Tuller B. The Bernstein perspectives: I. The problems of degrees of freedomand context-coordinations variability. in jas kelso (ed.), Human motor behavior. 1982; (pp. 239-252).
  31. Bardy BG, Marin L, Stoffregen TA, Bootsma RJ. Postural coordination modes considered as emergent phenomena. J Exp Psychol Hum Percept Perform. 1999;25(5):1284-301. doi: 10.1037//0096-1523.25.5.1284.
  32. Bardy BG, Oullier O, Bootsma RJ, Stoffregen TA. Dynamics of human postural transitions. J Exp Psychol Hum Percept Perform. 2002;28(3):499-514.
  33. Heiderscheit BC. Movement variability as a clinical measure for locomotion. Journal of Applied Biomechanics. 2000;16(4):419-27. doi: 10.1123/jab.16.4.419
  34. Landes S, Nyland J, Elmlinger B, Tillett E, Caborn D. Knee flexor strength after ACL reconstruction: comparison between hamstring autograft, tibialis anterior allograft, and non-injured controls. Knee Surg Sports Traumatol Arthrosc. 2010;18(3):317-24. doi: 10.1007/s00167-009-0931-9.
  35. Faul F, Erdfelder E, Buchner A, Lang AG. Statistical power analyses using G*Power 3.1: tests for correlation and regression analyses. Behav Res Methods. 2009 Nov;41(4):1149-60. doi: 10.3758/BRM.41.4.1149.
  36. Faul F, Erdfelder E, Lang AG, Buchner A. G*Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods. 2007 May;39(2):175-91. doi: 10.3758/bf03193146.
  37. Vairo GL, Myers JB, Sell TC, Fu FH, Harner CD, Lephart SM. Neuromuscular and biomechanical landing performance subsequent to ipsilateral semitendinosus and gracilis autograft anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc. 2008;16(1):2-14. doi: 10.1007/s00167-007-0427-4.
  38. Davis K, Williams JL, Sanford BA, Zucker-Levin A. Assessing lower extremity coordination and coordination variability in individuals with anterior cruciate ligament reconstruction during walking. Gait Posture. 2019;67:154-159. doi: 10.1016/j.gaitpost.2018.10.010.
  39. Sanford BA, Williams JL, Zucker-Levin A, Mihalko WM. Asymmetric ground reaction forces and knee kinematics during squat after anterior cruciate ligament (ACL) reconstruction. Knee. 2016;23(5):820-5. doi: 10.1016/j.knee.2015.11.001.
  40. Pollard CD, Stearns KM, Hayes AT, Heiderscheit BC. Altered lower extremity movement variability in female soccer players during side-step cutting after anterior cruciate ligament reconstruction. Am J Sports Med. 2015 Feb;43(2):460-5. doi: 10.1177/0363546514560153.
  41. Gribbin TC, Slater LV, Herb CC, Hart JM, Chapman RM, Hertel J, Kuenze CM. Differences in hip-knee joint coupling during gait after anterior cruciate ligament reconstruction. Clin Biomech (Bristol, Avon). 2016;32:64-71. doi: 10.1016/j.clinbiomech.2016.01.006.
  42. Heiderscheit BC, Hamill J, van Emmerik RE. Variability of stride characteristics and joint coordination among individuals with unilateral patellofemoral pain. Journal of applied biomechanics. 2002;18(2):110-21. doi: 10.1123/jab.18.2.
  43. Seay JF, Van Emmerik RE, Hamill J. Low back pain status affects pelvis-trunk coordination and variability during walking and running. Clin Biomech (Bristol, Avon). 2011;26(6):572-8. doi: 10.1016/j.clinbiomech.2010.11.012.
  44. Van Emmerik RE, Wagenaar RC, Winogrodzka A, Wolters EC. Identification of axial rigidity during locomotion in Parkinson disease. Arch Phys Med Rehabil. 1999;80(2):186-91. doi: 10.1016/s0003-9993(99)90119-3.
  45. Kiefer AW, Ford KR, Paterno MV, Schmitt LC, Myer GD, Riley MA, Shockley K, Hewett TE. Inter-segmental postural coordination measures differentiate athletes with ACL reconstruction from uninjured athletes. Gait Posture. 2013;37(2):149-53. doi: 10.1016/j.gaitpost.2012.05.005.
  46. Rebmann D, Mayr HO, Schmal H, Hernandez Latorre S, Bernstein A. Immunohistochemical analysis of sensory corpuscles in human transplants of the anterior cruciate ligament. J Orthop Surg Res. 2020;15(1):270. doi: 10.1186/s13018-020-01785-5.
  47. Rodriguez-Merchan EC, Encinas-Ullan CA. Knee Osteoarthritis Following Anterior Cruciate Ligament Reconstruction: Frequency, Contributory Elements, and Recent Interventions to Modify the Route of Degeneration. Arch Bone Jt Surg. 2022 Nov;10(11):951-958. doi: 10.22038/ABJS.2021.52790.2616.
The Archives of Bone and Joint Surgery
Volume 11, Issue 12
December 2023
Pages 770-776

Files

History

  • Receive Date: 14 August 2023
  • Revise Date: 06 October 2023
  • Accept Date: 30 October 2023

Share

How to cite

Statistics