Sensorimotor Dysfunction Following Anterior Cruciate Ligament Reconstruction- an Afferent Perspective: A Scoping Review.
Thilina N Vitharana, Enda King, Kieran Moran
PMID 38179582WHAT IT FOUND
People after ACL reconstruction show altered brain processing of sensation and vision.
Tests of knee position and motion gave mixed small differences, and clinic tools are limited, so these deficits may not be reliably measured.
Key findings
01Across studies, people after ACL reconstruction showed consistent differences in central processing of somatosensory information compared with their other limb and healthy controls.
02When the reconstructed knee was compared with the person's other knee, 13 of 27 joint position sense studies found reduced function, 20 found no significant difference, and 2 found improved function.
03Five of six studies comparing ACLR participants with healthy controls found increased visual processing activity in the brain during simple movements.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The review did not appraise study quality, so bias in the included studies was not assessed. Most included studies were retrospective, so the review cannot show whether differences existed before injury or surgery. Outcome measures varied widely, and many did not report reliability or standard error, so small differences may not be meaningful. Some participants were more than two years post-surgery and had returned to general activity, which may confound results. The review mapped sensory and visual measures but did not link them to patient outcomes or test interventions. EEG and functional MRI findings are not practical for most clinics.
Declared interests
The authors reported no conflicts of interest and no funding.
The easy way to misread this
Do not conclude that specific sensorimotor or visual training has been shown to improve outcomes after ACL reconstruction. This scoping review maps differences and measurement problems, but it did not test interventions and did not assess patient outcomes.