title: Follow-up evaluation 2 years after ACL reconstruction with bone-patellar tendon-bone graft shows that excessive tibial rotation persists.
abstract: OBJECTIVE
  To investigate in vivo if the increased tibial rotation found in anterior cruciate ligament (ACL)-deficient patients before surgery is restored 2 years after the reconstruction, during 2 high-demanding activities.
  
  
  METHODS
  Prospective follow-up study.
  
  
  METHODS
  A gait analysis laboratory.
  
  
  METHODS
  Nine subjects with unilateral ACL rupture, reconstructed with a bone-patellar tendon-bone (BPTB) graft, and 10 healthy control subjects.
  
  
  METHODS
  All the ACL-deficient patients underwent a unilateral ACL reconstruction after prereconstruction data acquisition.
  
  
  METHODS
  Using a 6-camera motion analysis system, kinematics were collected as subjects (1) descended from a stair and, after foot contact, pivoted on the landing leg at 90 degrees; and (2) jumped from a platform, landed with both feet on the ground and, after foot contact, pivoted on the right or left leg at 90 degrees in a similar fashion. The dependent variable examined was the maximum range of motion of tibial rotation during the pivoting period.
  
  
  RESULTS
  For both activities, no significant differences were found between the control healthy knee and the intact knee of the patient group before and 2 years after the ACL reconstruction. Significant differences were found between the control healthy knee and the affected knee of the patients group for both activities, both before and 2 years after the ACL reconstruction.
  
  
  CONCLUSIONS
  The increased tibial rotation found in the ACL-deficient knees was not restored with reconstruction using a BPTB graft, even 2 years postoperatively. The authors propose that this excessive tibial rotation over time may lead to further deterioration of the knee resulting from abnormal loading at areas of the cartilage that are not commonly loaded in a healthy knee.
authors.affiliation: Orthopaedic Sports Medicine Center of Ioannina, Department of Orthopaedic Surgery, University of Ioannina, Greece.
authors.forename: Stavros
authors.initials: S
authors.lastname: Ristanis
authors.forename: Nicholas
authors.initials: N
authors.lastname: Stergiou
authors.forename: Kostas
authors.initials: K
authors.lastname: Patras
authors.forename: Elias
authors.initials: E
authors.lastname: Tsepis
authors.forename: Constantina
authors.initials: C
authors.lastname: Moraiti
authors.forename: Anastasios D
authors.initials: AD
authors.lastname: Georgoulis
mesh_terms: D000328:Adult; D016118:Anterior Cruciate Ligament / Q000601:surgery; D050376:Bone-Patellar Tendon-Bone Grafting; D016022:Case-Control Studies; D005500:Follow-Up Studies; D005684:Gait / Q000502:physiology; D006801:Humans; D007717:Knee / Q000503:physiopathology* / Q000601:surgery; D008297:Male; D012399:Rotation; D013977:Tibia / Q000503:physiopathology* / Q000601:surgery; D016896:Treatment Outcome