title: Preoperative and postoperative serial assessments of postural balance and fall risk in patients with arthroscopic anterior cruciate ligament reconstruction.
abstract: BACKGROUND
  Impaired postural balance due to somatosensory data loss with mechanical instability has been shown in patients with ACL deficiency.
  
  
  OBJECTIVE
  To assess postural balance in patients with ACL insufficiency prior to surgery and following reconstruction with serial evaluations.
  
  
  METHODS
  Thirty patients (mean age of 27.7 ± 6.7 years) who underwent arthroscopic reconstruction of ACL with bone-patellar tendon-bone autograft were examined for clinical and functional variables at preoperative day and postoperative 12th week. Posturographic analysis were performed by using Tetrax Interactive Balance System (Sunlight Medical Ltd, Israel) at preoperative day, at 4th, 8th, and 12th weeks following reconstruction. Data computed by posturographic software by the considerations of the oscillation velocities of body sways is fall risk as a numeric value (0-100, lower values indicate better condition).
  
  
  RESULTS
  All of the patients (mean age of 27.7 ± 6.7 years) had significant improvements for clinical, functional evaluations and fall risk (p< 0.05). Mean fall risk was within high-risk category (59.9 ± 22.8) preoperatively. The highest fall risk was detected at postoperative 4th week. Patients had high fall risk at 8th week similar to preoperative value. Mean fall risk decreased to low level risk at 12th week. Preoperative symptom duration had relationships with preoperative fall risk and postoperative improvement of fall risk (p= 0.001, r= -0.632, p= 0.001, r= -0.870, respectively). The improvement of fall risk was higher in patients with symptoms shorter than 6 months (p= 0.001).
  
  
  CONCLUSIONS
  According to these results, mean fall risk of patients with ACL insufficiency was within high risk category preoperatively, and fall risk improves after surgical reconstruction, but as the duration of complaints lengthens especially longer than 6 months, the improvement of fall risk decreases following reconstruction.
authors.affiliation: Department of Orthopedics and Traumatology, Medicine Faculty, Pamukkale University, Denizli, Turkey.
authors.forename: Oguzhan
authors.initials: O
authors.lastname: Gokalp
authors.affiliation: Department of Orthopedics and Traumatology, Medicine Faculty, Pamukkale University, Denizli, Turkey.
authors.forename: Semih
authors.initials: S
authors.lastname: Akkaya
authors.affiliation: Department of Physical Medicine and Rehabilitation, Faculty of Medicine, University of Pamukkale, Denizli, Turkey.
authors.forename: Nuray
authors.initials: N
authors.lastname: Akkaya
authors.affiliation: School of Physical Therapy and Rehabilitation, University of Pamukkale, Denizli, Turkey.
authors.forename: Nihal
authors.initials: N
authors.lastname: Buker
authors.affiliation: Department of Orthopedics and Traumatology, Medicine Faculty, Pamukkale University, Denizli, Turkey.
authors.forename: Harun R
authors.initials: HR
authors.lastname: Gungor
authors.affiliation: Department of Orthopedics and Traumatology, Medicine Faculty, Pamukkale University, Denizli, Turkey.
authors.forename: Nusret
authors.initials: N
authors.lastname: Ok
authors.affiliation: Department of Orthopedics and Traumatology, Medicine Faculty, Pamukkale University, Denizli, Turkey.
authors.forename: Cagdas
authors.initials: C
authors.lastname: Yorukoglu
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control* / Q000706:statistics & numerical data; D000328:Adult; D016118:Anterior Cruciate Ligament / Q000503:physiopathology* / Q000601:surgery; D059549:Anterior Cruciate Ligament Reconstruction / Q000379:methods*; D001182:Arthroscopy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011184:Postoperative Period; D004856:Postural Balance / Q000502:physiology*; D057234:Preoperative Period; D018570:Risk Assessment / Q000379:methods*; D016896:Treatment Outcome; D055815:Young Adult
keywords: Postural balance; anterior cruciate ligament; fall risk; reconstruction