Knee proprioception four months after anterior cruciate ligament reconstruction: Impact of limb dominance, anterolateral procedure, and association with readiness to return to sport

Abstract

Background

Knee proprioception may be compromised after anterior cruciate ligament reconstruction (ACLR), but associated factors and impact remain unclear. This study evaluated knee proprioception 4 months after primary ACLR, compared with healthy controls, and explored the impacts of leg dominance, anterolateral procedures (AEAPs), and their association with psychological readiness to return to sports.

Methods

This prospective cohort study included 30 ACLR participants and 20 healthy controls. Isokinetic testing measured knee strength and proprioception, using passive joint position sense (JPS1: detection, JPS2: repositioning) and kinesthesia (threshold to detection of passive motion). At 8 months, ACLR participants completed the ACL-RSI scale to assess psychological readiness to return to sports.

Results

At 4 months postoperative, kinesthesia was better in the operated limb than the non-operated limb (p = 0.008), but position sense did not differ significantly. There were no significant differences in kinesthesia or position sense between ACLR participants and controls. The operated limb had worse JPS2 if the ACLR was on the non-dominant side. Proprioception was unaffected by AEAPs, and only repositioning showed a moderate, non-significant correlation with ACL-RSI (r = −0.377).

Conclusion

At 4 months post-ACLR, kinesthesia improved in the operated leg; dominance influenced position sense, highlighting the need for personalized rehabilitation.