Abstract
Introduction and Aims: A variety of factors have been associated with difficulty in regaining normal knee motion following anterior cruciate ligament surgery. The purpose of this study was to determine if increased swelling in the early post-operative period is predictive of difficulty in regaining full range of motion after ACL reconstruction.
Method: 118 consecutive patients were prospectively assessed post-ACL reconstruction. Range of motion was measured by goniometer at week one, four and eight. A deficit greater than 10 degrees of flexion or five degrees of extension (compared to normal leg) at the eight-week mark were defined as significant. The grade of hemarthrosis and circumference of the leg at the level of the patella were recorded at the same intervals. All patients underwent endoscopic, primary, ACL reconstruction with a standardised post-op physio protocol. Exclusion criteria included previous surgery on either knee, significant effusion at the time of surgery or associated ligament injuries.
Results: Patients with a higher grade of hemarthrosis at one week were more likely to have a flexion deficit at eight weeks (P=0.002, relative risk 1.93). Increased circumference was also associated with a flexion deficit at eight weeks (P=0.007, relative risk 1.37). The presence of a large hemarthrosis was not associated with an extension deficit at (P=0.47), although there was a trend for increased circumference to be associated with extension deficit (P=0.07). The patients that had difficulty in regaining full range of motion were similar to the rest of the cohort with regards to patient age, sex, time to surgery, graft type, incidence and treatment of meniscal pathology.
Conclusions: Increased swelling, at one-week post-op (presence of a large hemarthrosis or a measured circumference greater than 1.5cm more than the control limb) is associated with flexion loss at eight weeks post-surgery. These patients merit closer observation and possibly a modified rehabilitation protocol.
These abstracts were prepared by Editorial Secretary, George Sikorski. Correspondence should be addressed to Australian Orthopaedic Association, Ground Floor, The William Bland Centre, 229 Macquarie Street, Sydney, NSW 2000, Australia.
One or more of the listed authors are receiving or have received benefits or support from a recognised academic body for the pursuance of the study.
