Yaseen, Mohsin Khaleel (2025) Influence of Early Flexion ROM on the Graft Laxity After ACL Reconstructive Surgery. International Journal of Health Systems and Medical Sciences, 4 (4). ISSN 2833-7433

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Abstract

Background: Anterior cruciate ligament (ACL) reconstruction is one of the most frequently performed surgical procedures for the treatment of symptomatic anterior cruciate ligament (ACL) instability, especially in healthy young, active patients. Knee range of motion (ROM), muscle function and return to normal daily and sporting activity are all important factors in successful recovery after ACL reconstruction as well as restoration of ligament stability. It is important to restore knee motion as early as possible after surgery, but questions also might present themselves about the effects of early flexion on the stability or laxity of the reconstructed graft. Objective: The purpose of this study was to assess early postoperative knee flexion range of motion (ROM) and the association of this with subsequent clinical graft laxity after ACL reconstruction with a hamstring autograft. Patients and Methods: A total of 42 patients who underwent primary ACL reconstruction were included in the study. Inclusion criteria included: Primary ACL reconstruction, isolated ACL injury, age range of 18 to 40 years, and hamstring autograft reconstruction at Al-Tawfiq Private Hospital from May 2023 to May 2025. The surgeries were performed in the same orthopedic practice, and the outcomes were monitored for about 12 months. Knee ROM was measured with a goniometer at 1-week, 1-month and 3-month postoperative periods. The Lachman and anterior drawer test were performed at 6 and 12 months postoperatively to determine the stability of the graft, compared with the opposite knee. Results: Mean age of the patients was 27.8±5.95 years and the age range were 18-40 years. There were 35 male and 7 female patients. In 28 patients, the right knee and in 14 patients, the left knee was involved. The most prevalent mechanism of injury was sports injuries with 30 cases. The average length of the graft used was 23.4 cm and the average graft diameter used was 8.9 mm. The mean follow-up period was 11.5 months. Mean knee ROM increased from 65.95 ± 10.64° at 1 week postoperatively to 106.66 ± 9.78° at 1 month and 138.8 ± 6.87° at 3 months. The Lachman test was Grade 0 in 28 patients, grade 1 in 12 patients, grade 2 in 2 patients and grade 3 in no patient at 6 months. At 12 months, the results were: Grade 0 28 patients; Grade 1 11 patients; Grade 2 2 patients; Grade 3 1 patient. In 6 months, 30 patients had Grade 0, 10 had Grade 1, 2 had Grade 2, and 0 had Grade 3 on the anterior drawer test, while 30 patients had Grade 0, 9 patients had Grade 1, 2 patients had Grade 2 and 1 patient had Grade 3 on the anterior drawer test in 12 months. Conclusion: Knee flexion was gradually increasing in the first 3 months after ACL reconstruction. Most of the patients had minimal clinical laxity or none at all at 6- and 12-months follow-up. The results underscore the value of early ROM recovery as part of the post-operative therapy.

Item Type:	Article
Uncontrolled Keywords:	Anterior cruciate ligament, ACL reconstruction, range of motion, knee flexion, graft laxity, Lachman test, anterior drawer test, hamstring autograft
Subjects:	H Social Sciences
Depositing User:	admin eprints
Date Deposited:	04 Nov 2026 08:51
Last Modified:	04 Nov 2026 08:51
URI:	http://eprints.umsida.ac.id/id/eprint/17450

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