Alterations in sensorimotor function after ACL reconstruction during active joint position sense testing. A systematic review

Abstract

Background The anterior cruciate ligament (ACL) rupture can lead to impaired knee function. Reconstruction decreases the mechanical instability but might not have an impact on sensorimotor alterations. Objective Evaluation of the sensorimotor function measured with the active joint position sense (JPS) test in anterior cruciate ligament (ACL) reconstructed patients compared to the contralateral side and a healthy control group. Methods The databases MEDLINE, CINAHL, EMBASE, PEDro, Cochrane Library and SPORTDiscus were systematically searched from origin until April 2020. Studies published in English, German, French, Spanish or Italian language were included. Evaluation of the sensorimotor performance was restricted to the active joint position sense test in ACL reconstructed participants or healthy controls. The Preferred Items for Systematic Reviews and Meta-Analyses guidelines were followed. Study quality was evaluated using the Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. Data was descriptively synthesized. Results Ten studies were included after application of the selective criteria. Higher angular deviation, reaching significant difference (p < 0.001) in one study, was shown up to three months after surgery in the affected limb. Six months post-operative significantly less error (p < 0.01) was found in the reconstructed leg compared to the contralateral side and healthy controls. One or more years after ACL reconstruction significant differences were inconsistent along the studies. Conclusions Altered sensorimotor function was present after ACL reconstruction. Due to inconsistencies and small magnitudes, clinical relevance might be questionable. JPS testing can be performed in acute injured persons and prospective studies could enhance knowledge of sensorimotor function throughout the rehabilitative processes.

Ambulatory knee biomechanics and muscle activity 2 years after ACL surgery: InternalBraceTM-augmented ACL repair versus ACL reconstruction versus healthy controls

“…However, we did not observe significant differences between the two groups of patients, which may be due to a slightly underpowered ACL-R group. The impairments in semitendinosus muscle function [ 4 , 57 – 59 ] and proprioception [ 60 ] reported after ACL-R may explain the observed differences compared to controls. However, the presumed preservation of proprioception after ACL-IB remains unclear.…”

Reliability of the active knee joint position sense test and influence of limb dominance and sex

“…The JPS test examines the ability to reproduce a prior presented angle by a body segment 5 . The assessment can be conducted under active or passive conditions.…”

“…Moreover, studies have revealed sensorimotor alterations after joint injury, e.g., anterior cruciate ligament (ACL) rupture and reconstruction 5 , 13 . It is assumed that these alterations are related to impaired muscle functionality and diminished activity level or balance abilities after ACL injury 14 , 15 .…”

“…It is assumed that these alterations are related to impaired muscle functionality and diminished activity level or balance abilities after ACL injury 14 , 15 . Thus, especially in the early phase of rehabilitation, sensorimotor tests can be used as outcome measures of improvement after joint injury or diseases 5 , 12 . To the authors knowledge no study has previously focused on muscle activation patterns during an active knee JPS test.…”

“…This might be the reason for diverse results on the influence of leg dominance and sex 12 . Therefore, to contribute and expand current knowledge, the focus of the present manuscript was on the influence of leg dominance as well as sex and the corresponding quality measures of the assessments.Moreover, studies have revealed sensorimotor alterations after joint injury, e.g., anterior cruciate ligament (ACL) rupture and reconstruction 5,13 . It is assumed that these alterations are related to impaired muscle functionality and diminished activity level or balance abilities after ACL injury 14,15 .…”