Assessment of Landing Stability in Patients After Anterior Cruciate Ligament Injury and Reconstruction: A Systematic Review and Meta-analysis

Abstract

Context:

Dynamic postural control deficits are prevalent in people with anterior cruciate ligament injury (ACLI) or reconstruction (ACLR). Time to stabilization (TTS) and the dynamic postural stability index (DPSI) are used to assess dynamic postural stability during a jump-landing task. However, results vary on whether landing stability can adequately demonstrate dynamic postural deficits in patients with ACLI and ACLR.

Objective:

To (1) describe common methods and parameters for determining TTS and DPSI, and (2) identify the differences in TTS and DPSI across different jump-landing tasks and directions between the ACLI or ACLR and control groups.

Data Sources:

PubMed, Embase, Web of Science, Cochrane Library, Scopus, CINAHL, and SPORTDiscus were searched for articles from conception until March 2024.

Study Selection:

Clinical studies assessing dynamic postural stability between patients with ACLI and ACLR and controls were included. Eleven articles were included in the analysis.

Study Design:

Systematic review and meta-analysis.

Level of Evidence:

Level 4.

Data Extraction:

The following information was extracted from included articles: demographic data, sample size, methodology, landing stability test outcomes, and calculation methods of outcomes. Different jump tasks were explored, and meta-analyses were conducted on the landing stability test outcomes.

Results:

In forward jump-landing tasks, knees affected by ACLI or ACLR needed more time than controls to achieve stabilization, showing a moderate effect in the anteroposterior direction (based on 2 studies, 47 affected knees versus 44 healthy knees; standardized mean difference [SMD] = 0.438), and a large effect in the vertical direction (based on 3 studies, 77 affected knees versus 74 healthy knees; SMD = 0.656).

Conclusion:

These findings demonstrate impaired dynamic stability in ACLI/ACLR patients, highlighting the importance of TTS as an effective measure for assessing landing stability.