Postural Stability in Men with Anterior Cruciate and Bicruciate Ligament Knee Injury

Abstract

Background. Knee ligaments are not only recognized as mechanical stabilizers, but also as sensorimotor components contributing to the proprioceptive feedback mechanisms and neuromuscular stabilization of knee joint. The study investigated the influence of isolated and bicruciate ligament injury of cruciate ligaments on postural stability in male individuals prior to reconstruction surgery. Materials and methods. An individual case, control study design was used. Thirty-six patients were categorized into three groups depending on a history of a recent knee joint: ACL group with an anterior cruciate ligament injury, BCL group with an anterior and posterior cruciate ligament injury and control group with no knee injury and no lower limb injury during last 12 months. Postural stability was expressed by body sways (angular degrees, º) in the antero-posterior (AP-Shift), latero-medial (LM-Shift) and in both planes (2D-Shift) assessed with a Delos Postural System in standing one leg position with and without visual control. Non-parametric Kruskal-Wallis and Mann-Whitney U tests were used to assess changes between studied variables. Results. There was statistical difference between individuals with BCL who had higher body sways with closed eyes in all examined planes while standing on the affected limb compared to control and their own unaffected limbs (p < 0.05). Additionally, AP-Shift and 2D-shift were higher in BCL group than in the ACL injured group with eyes closed (p < 0.05). The ratio of body sways between closed and open eyes was greater in the BCL group in all planes for both limbs than in the healthy men (p < 0.05). In BCL and ACL groups the ratio of body sway distribution during stability tests was two times higher in the injured limb than in the uninjured one (p < 0.05). There was statistical difference in AP-Shift between participants with ACL and BCL injury in affected and unaffected limb (p < 0.05). The only changed detected in the ACL group was increased body sway for all studied planes when standing on the injured limb with closed eyes as compared to standing with open eyes (p < 0.05). Conclusions. Under lack of visual cues, body sway increases in BCL but not ACL knee injured individuals suggesting a substantial decline in proprioceptive input after the bicruciate ligament rupture.