KNEE-JOINT ACCESSORY MOTION FOLLOWING ANTERIOR CRUCIATE LIGAMENT ALLOGRAFT RECONSTRUCTION - A PRELIMINARY-REPORT

Early in the postoperative period, changes in tibial translation have been noted in patient populations following anterior cruciate ligament reconstructive surgery. Deformation due to a lengthening of the ligam ent graft has been the most widely accepted reason for the change in t ibial translation. Treatment techniques have not been proven successfu l in the abatement or reversal of this graft lengthening The purpose o f this study was to investigate the effect of functional bracing on ti bial translation during the first year postoperatively in a group of p atients with early changes in tibial translation. Three consecutive pa tients with early increases in KT-2000 manual maximum total drawer fol lowing bone-patellar tendon-bone allograft reconstruction were identif ied as subjects in the control group. Five consecutive anterior crucia te ligament bone-patellar tendon-bone allografts with early increases in KT-2000 manual maximum total drawer were identified as subjects in the treatment group. These patients were followed monthly during the f irst year postoperatively by manual maximum total drawer KT-2000 testi ng. Criteria for inclusion in the treatment and control groups include d KT-2000 testing, with an increase in translation of greater than or equal to 2 mm when compared with the uninvolved knee during the first year postoperatively. The treatment group was required to wear a funct ional knee brace during all weight-bearing activities until KT-2000 di splacement measures were stabilized for 3 consecutive months. Treatmen t with the functional brace resulted in a mean 2.3-mm decrease in tibi al translation in the manual maximum total drawer KT-2000 when compari ng the involved and uninvolved knee prebracing with posttreatment. All five subjects in the treatment group had a decrease in tibial transla tion. A Median Test comparing the control and treatment group's KT-200 0 scores was significant at the p < .05 level. Patients who experience early increases in tibial translation with anterior cruciate ligament reconstructions may be assisted in a reduction of the displacement by the use of a functional brace.