Influence of hip restriction on noncontact ACL rerupture.

Abstract

This study investigated variables associated with hip restriction (reduced range of motion) in a group of soccer players presenting with noncontact rerupture of the anterior cruciate ligament (ACL) and compared results with a group of sport-matched healthy professional athletes. In this case series, 28 male soccer players with noncontact ACL rerupture were examined for clinical hip range of motion findings potentially associated with ACL rerupture, namely anterior knee displacement, internal-external hip rotation, and cruciate ligament insufficiency. Results were compared with data obtained from 27 healthy professional players. Patients presenting gross surgical errors (e.g. poorly positioned tunnel) or reporting major accidents affecting the lower limbs, such as leg or ankle fractures, were excluded from analysis. Internal-external rotation was measured in the supine position, with knee and hip at 90° of flexion. ACL insufficiency was assessed using the Pivot Shift test and the Lachman's test with the aid of a Rolimeter RM(®) arthrometer and confirmed by magnetic resonance imaging. The most prevalent finding was a significantly lower mean internal-external hip rotation in the rerupture group (45.0°) when compared with healthy professional soccer players (56.2°). Assessing hip restriction in patients presenting noncontact ACL rerupture showed to be extremely important during ACL reconstruction planning.