| Abstract
Background Disruption of the anterior cruciate ligament
(ACL) is one of the most frequent musculoskeletal injuries
affecting physically active men and women. In the United
States, an estimated 200,000 ACL reconstructions are
performed annually. One of the most common complications
of ACL reconstruction is loss of extension. The
purpose of this study was to assess the effects of the
hyperextension maneuver on preventing knee extension
loss after arthroscopic ACL reconstruction.
Materials and methods In this prospective randomized
clinical trial study, 100 adult patients with a documented
complete ACL tear were randomized to two groups. All
patients underwent arthroscopic ACL reconstruction with
quadrupled semitendinosus and gracilis autograft by the
senior author based on the same technique and instruments.
However, the hyperextension maneuver was only performed
in 50 patients during autograft fixation on the tibial
side (case group). The postoperative rehabilitation protocol
was similar for both groups. The knee range of motion and
extension limit was evaluated at 2, 6, 12, and 24 weeks and
at 1 year postoperatively.
Results One hundred patients (88 male and 12 female)
aged from 17-36 years (average 26.9 years) were
included in our study. The two groups were similar
regarding age, sex, and dominant side involvement
(P[0.4).The difference between the two groups was significant
only at 2 weeks (P \0.02). After 2 weeks,
although the rate of limited extension was higher in the
control group, no significant difference was seen between
the groups.
Conclusion Although the hyperextension technique during
graft fixation on the tibial side may induce better range of
motion in the first 2 weeks after ACL reconstruction surgery,
this effect is not significant after 2 weeks.
Level of evidence Therapeutic level II. |