Evaluation of plantar pressure distributions in patients with anteriorcruciate ligament deficiency: preoperative and postoperative changes

Abstract

Background/aim: Anterior cruciate ligament (ACL) deficiency results in several kinematic changes in the lower extremities. The aim of this study is to define the plantar pressure parameters in ACL-deficient patients and to show the effect of ACL reconstruction on dynamic plantar pressure.Materials and methods: Forty patients with unilateral ACL rupture and 40 healthy controls were included in this study. Dynamic plantar pressures of both groups were recorded by the EMED SF-2 system during level walking. Thirteen of the patients who had ACL reconstructions with hamstring autografts (HS group) were reevaluated at an average of 14.5 months following the ACL reconstructions.Results: ACL-deficient patients had significantly lower hindfoot (P = 0.007) but higher midfoot pressure values (P = 0.03) on their ipsilateral foot compared to control group subjects. Ipsilateral hindfoot pressures were also found to be significantly lower than those of the contralateral foot (P = 0.001). Hindfoot pressure values of the HS group were increased in postoperative measurements (P = 0.01). Conclusion:ACL-deficient patients have altered plantar pressure distributions and ACL reconstructions restore these changes to normal. Pedobarography might be used as a practical method for dynamic functional assessment of ACL-deficient patients.

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“…In Group A, the COPAP (Anteroposterior Center of Pressure) measure was 17.79 cm (±0.82), contrasting with the 25.10 cm (±1.04) observed in Group B. This difference was statistically significant (p=0.01) [5][6][7][8][9].…”

“…Regarding the plantar distribution in the Rearfoot (heel) and Forefoot (toes), the plantar pressure measures in both groups did not reveal significant differences between the right and left foot. However, a trend of higher pressure in the Forefoot compared to the Rearfoot was observed in both groups [5][6][7][8][9].…”

“…As for the COPML (Mediolateral Center of Pressure) measure, Group A presented 14.47 cm (±9.99), while Group B recorded 10.80 cm (±0.69). Again, the difference between the groups was statistically significant (p=0.01) [5][6][7][8][9].…”

“…The lack of significant differences in plantar pressure measures between the groups could suggest that the impact of an ACL rupture on plantar pressure distribution may be less pronounced than its impact on the center of pressure measures [7][8][9]. However, more research is needed to further investigate this.…”

“…Thus, while the COPAP and COPML measures showed significant differences, the plantar pressure measures did not demonstrate relevant disparities. This suggests that a complete rupture of the Anterior Cruciate Ligament (ACL) may significantly influence the COPAP and COPML, but not necessarily the plantar pressure distribution [5][6][7][8][9].…”