Functional Performance Among Active Female Soccer Players After Unilateral Primary Anterior Cruciate Ligament Reconstruction Compared With Knee-Healthy Controls

Abstract

Background: Good functional performance with limb symmetry is believed to be important to minimize the risk of injury after a return to pivoting and contact sports after anterior cruciate ligament reconstruction (ACLR). Purpose: This study aimed to investigate any side-to-side limb differences in functional performance and movement asymmetries in female soccer players with a primary unilateral anterior cruciate ligament (ACL)–reconstructed knee and to compare these players with knee-healthy controls from the same soccer teams. Study Design: Cross-sectional study; Level of evidence, 3. Methods: This study included 77 active female soccer players at a median of 18 months after ACLR (interquartile range [IQR], 14.5 months; range, 7-39 months) and 77 knee-healthy female soccer players. The mean age was 20.1 ± 2.3 years for players with an ACL-reconstructed knee and 19.5 ± 2.2 years for controls. We used a battery of tests to assess postural control (Star Excursion Balance Test) and hop performance (1-legged hop for distance, 5-jump test, and side hop). Movement asymmetries in the lower limbs and trunk were assessed with the drop vertical jump and the tuck jump using 2-dimensional analyses. Results: The reconstructed and uninvolved limbs did not differ in any of the tests. In the 5-jump test, players with an ACL-reconstructed knee performed worse than controls (mean 8.75 ± 1.05 m vs 9.09 ± 0.89 m; P = .034). On the drop vertical jump test, the ACL-reconstructed limb had significantly less knee valgus motion in the frontal plane (median 0.028 m [IQR, 0.049 m] vs 0.045 m [IQR, 0.043 m]; P = .004) and a lower probability of a high knee abduction moment (pKAM) (median 69.2% [IQR, 44.4%] vs 79.8% [IQR, 44.8%]; P = .043) compared with the control players’ matched limb (for leg dominance). Results showed that 9% to 49% of players in both groups performed outside recommended guidelines on the different tests. Only 14 players with an ACL-reconstructed knee (18%) and 15 controls (19%) had results that met the recommended guidelines for all 5 tests (P = .837). Conclusion: The reconstructed and uninvolved limbs did not differ, and players with an ACL-reconstructed knee and controls differed only minimally on the functional performance tests, indicating similar function. It is worth noting that many players with an ACL-reconstructed knee and controls had movement asymmetries and a high pKAM pattern, which have previously been associated with an increased risk for both primary and secondary ACL injury in female athletes.<p>Funding agencies: Futurum the Academy for Healthcare; Region Jonkoping County; Medical Research Council of Southeast Sweden; Faculty of Health Sciences at Linkoping University; Swedish Research Council for Sport Science; Swedish Football Association</p

La vuelta al fútbol tras la reconstrucción del ligamento cruzado anterior

“…Mientras que Waldén et al 10 y Guzzini et al 11 confirman una tasa de RPD del 100%, existen porcentajes más bajos tanto en el estudio de Sandon et al 12 como en el de Fältström et al 2 con un 54.1% y un 52% respectivamente. Las tasas de RPD extremidad reconstruida en comparación con la extremidad no afectada, difiriendo sólo mínimamente en algunas pruebas con los jugadores sanos 19 . Además, Thomson et al 18 apuntan que existe una descarga de peso relativamente grande de la extremidad operada a pesar de haberse completado el RPD.…”

“…A la hora del RPD tras la reconstrucción, no todos los participantes lo pueden hacer al mismo nivel previo a la lesión. En el estudio de Howard et al15 sólo el 75% vuelve a la misma categoría mientras que en otros cuatro estudios sí consiguen completar el RPD en el mismo nivel10,14,16,17 .En relación al rendimiento, sólo lo analizan tres estudios[17][18][19] . Se indica que no hay diferencias significativas entre el nivel anterior y posterior a la lesión17 , ni tampoco hubo deficiencias en la…”

Female Soccer Players With Anterior Cruciate Ligament Reconstruction Have a Higher Risk of New Knee Injuries and Quit Soccer to a Higher Degree Than Knee-Healthy Controls

“…Many young athletes return to knee-strenuous sports after ACLR, often without recovering sufficient muscle function. 7 Many young female soccer players, with and without ACLR, have movement asymmetries and a high knee abduction moment, 12 which might predispose them to increased risk for primary 21 and secondary ACL injury. 23,31 Functional performance and individualized rehabilitation are important after ACLR.…”

Jump performance in male and female football players

“…The women in this study have been previously reported on in a larger cohort study examining women football players after ACL reconstruction and their uninjured peers [6]. Study methodology is presented here in brief as the methods are similar to the previous study [6]. All players received written and verbal information about the study, and gave written informed consent prior to testing.…”

“…Inclusion criteria for this study were football players, between the ages of 16-25, with no history of ACL injury. The forty-six women included in this study were recruited as previously described [6], and selected from the larger female cohort because appropriately matched male football players were identified. The forty-six male football players were recruited from local football teams via word of mouth, coaches, and short presentations by the researchers to the team and matched to the women based on age, training frequency, and playing position ( Fig.…”