Sex related asymmetries after ACL reconstruction

The study of Di Stasi et al 2015 compared the lower limb mechanics of men and women athletes before and up to six months after an ACL reconstruction (ACLR).

Sample

39 non top athletes were appropriatelly screened as non coping individuals and underwent an ACLR (orthopaedic surgeon used a hamstring autograft or soft tisse allograft).

Intervention

Prior to the operation all participants received a 10 session programme which involved progressive quadriceps strengthening (consisted of a weight-bearing, functional training, neuro-muscular electric stimulation and an isokinetic protocol). 18 from the 39 athletes received also a pertubation training (PERT) as part of another randomised controlled trial. Postop, a physical therapy programme was utilised for the decrease in effusion, strength,range of motion deficits and functional impairments.

Outcomes and measures

Hip / knee joint excursions and knee joint moments were examined.
A 3D camera and a 6 component force plate were used to gather walking gait mechanics

Results

The stydy showed sex related differences in kinematics before and after ACLR. Neither women nor men athletes did not demonstrate statistically significant gait kinematics in the affected limb before their operation. However, women athletes showed better results with the pre operative regime but increased asymmetries after the ACLR. Moreover, both female and male athletes did not continue to demonstrate improved mechanics in the post op period compared to the pre operative programme and adaptations to gait mechanics occured in both limbs.

Conclusion

Rehabilitation efforts should be unique and focus differently in men and women athletes. The effects of current neuromuscular training post ACLR are still under investigation since athletes are still on high risk of a second ACL injury (same or contralateral limb).