Purpose
Poor balance in anterior cruciate ligament reconstruction (ACLR) patients indicates neuromuscular control (NMC) deficits, which may be associated with altered cortical activation in the brain. This study examines cortical activation patterns in ACLR patients compared with healthy controls during a single‐leg balance task with and without visual feedback.
Methods
Thirteen ACLR patients (ACLR, 23.38 ± 3.38 years) and thirteen healthy controls (CONT, 23.54 ± 3.48 years) performed a single‐leg balance task with both visual feedback (VF) and non‐visual feedback (NVF) with continuous electroencephalograph (EEG) monitoring. Knee function was also evaluated through a subjective assessment survey.
Results
Frontal theta power was significantly higher with VF compared to NVF. Significant group‐by‐condition interaction effect for parietal alpha‐2 revealed that the CONT group had increased activation with VF, whereas the ACLR group had increased activation with NVF. A negative correlation emerged between KOS‐ADL in the ACLR group with parietal alpha‐2 during NVF and occipital alpha‐2 during VF.
Conclusion
ACLR patients had comparable single‐leg balance to healthy controls, yet different cortical activation patterns emerged on EEG. ACLR patients with better knee function showed greater cortical activation in the somatosensory and visual cortices. Further research should consider these cortical changes in restoration of balance after ACLR.
Case:
A 21-year-old male division I collegiate athlete presented for right knee pain, effusion, and mechanical symptoms. The patient was found to have 2.4 × 2-cm medial patellar facet, 1 × 0.8-cm central trochlea, and 2.5 × 3-cm lateral femoral condyle articular cartilage defects on arthroscopy. The patient was treated with a matrix-induced autologous chondrocyte implantation (MACI) procedure for all 3 lesions. At 9 months postoperatively, the patient returned to full American football activities and remains asymptomatic 16 months postoperatively.
Conclusion:
Multiple lesions and lesions involving the patellofemoral joint can be treated with a MACI procedure with short-term promising results in high-demand athletes.
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