Page 200 - Demo

Chapter 10198In Chapter 4 we analysed the correlation between knee kinematics and subjective knee function and psychological readiness to return to sports. Range of tibial rotation and anterior tibial translation were measured during both low- and high-demand tasks one year after ACL reconstruction. Subjects were asked to complete the International Knee Documentation Committee (IKDC) and the Anterior Cruciate Ligament- Return to Sports after Injury (ACL-RSI) questionnaires to assess self-reported knee function and psychological readiness to return to sports, respectively. This study showed that range of tibial rotation has a strong positive correlation with self-reported knee function and psychological readiness to return to sports in high-demand tasks but a negative correlation in low-demand tasks. In contrast, the association between anterior tibial translation and self-reported knee function and psychological readiness was negative and did not show a discrepancy between low- or high-demand tasks. The mean range of tibial rotation was smaller than previously reported for high-demand tasks, which may imply that the ‘greater’ range of tibial rotation, which is correlated to better subjective knee function and better psychological readiness to return to sports, may in fact be a manifestation of a more natural movement of the knee and not a sign of increased rotational laxity. We therefore conclude that more normal knee kinematics after ACLR correlate with better self-reported knee function and psychological readiness.In Chapter 5 we analysed the correlation between the steepness of the tibial plateau, also known as posterior tibial slope, and the range of tibial rotation and anterior tibial translation. Studies based on passive testing show a strong correlation between anterior tibial translation and amount of posterior tibial slope. It is unknown whether this correlation is also present in high-demand tasks, in which muscle activity becomes a relevant factor. The correlation between range of tibial rotation and amount of posterior tibial slope was unknown. We hypothesised that the difference between the slope of the medial and lateral plateaus might be of more importance than the actual amount of slope itself, in terms of rotation. Dynamic range of tibial rotation and dynamic anterior tibial translation were measured during high-demand tasks both before and after ACL reconstruction. The amount of posterior tibial slope was measured on MRI. Posterior tibial slope was measured in the medial and lateral compartments using Hudek’s circle method. A difference between the medial and lateral Mark Zee.indd 198 03-01-2024 08:56