Page 53 - Demo

ACL reconstruction is not the only factor controlling tibial rotation513IntroductionIn the population of young athletes, return to sports after ACL reconstruction (ACLR) has become an increasingly relevant outcome. A review of literature shows that a mere 55% of athletes can return to a competitive form of sports after ACLR.1 Historically, reconstruction techniques have focused on restoring anterior tibial translation. However, it is known that the ACL also plays an important role in limiting tibial rotation.13 Excessive tibial rotation can potentially lead to giving way. This persistent feeling of giving way may be a reason why athletes cannot perform at their pre-injury level of sports.Tibial rotation has so far been measured during low-to-moderatedemand tasks (e.g. walking, cutting, pivoting). Increased tibial rotation is demonstrated in chronic ACL deficiency compared to healthy knees. After ACLR, decreased rTR compared to healthy knees has been shown.7-10,12,22,25,26,29,31,36,40,42,43 Decreased tibial rotation after ACLR does not comply with a potential persistent feeling of giving way after ACLR. One reason might be, that up to now, subjects have not been tested under sports related circumstances. While cutting and pivoting are considered relevant for sports activities, hoptests have the potential to test the combination of eccentric and concentric power and strength and neuromuscular coordination and knee stability.37 We consider the fact that patients experience more rotational instability during high-demand activities like jumping, ultimately hampering return to sports rates. Successful performance on a battery of hop tests is recommended as one of the criteria for return to sports, as these tasks simulate high-demand activities during pivoting sports, albeit in a controlled environment.14,19,33Measuring tibial rotation during hop tests using motion capture systems may provide more insight into knee kinematics during return-to-sports activities.We hypothesize that range of tibial rotation (rTR) is greater in the ACL deficient knee compared to the contralateral intact knee and remain Mark Zee.indd 51 03-01-2024 08:56