Type of Article:  Original Research

Volume 5; Issue 4 (August 2017)

Page No.: 2225-2231

DOI: https://dx.doi.org/10.16965/ijpr.2017.178


Atul Mahajan *1, Anil Mehtani 2.

*1 Assistant Professor, Department of Orthopedics, Lady Hardinge Medical College, New Delhi, India.

2 Professor, Lady Hardinge Medical College, Delhi, India.

Address for Correspondence: Dr. Atul Mahajan, Assistant Professor. Department of Orthopedics, Lady Hardinge Medical College, New Delhi, India. Ph 919643597479 E-Mail: dratulmahajan84@gmail.com


Introduction: Decrease in proprioception and kinesthesia occurs after ACL injury. Changes occurring within the joint following injury affect normal recruitment and firing patterns of the surrounding musculature. There are little data in the literature with reference to effect of concomitant menisectomy on recovery of proprioceptive deficits after arthroscopic ACL reconstruction.

Objective: To determine the effect of concomitant menisectomy  on proprioception recovery after arthroscopically assisted anterior cruciate ligament (ACL) reconstruction with quadrupled hamstring graft.

Materials and Methods: In this study, 42 arthroscopic ACL reconstruction patients were randomized into Group ACL+MM which underwent ACL reconstruction and menisectomy for concomitant meniscal tears and Group ACL who underwent ACL reconstruction alone. Outcome Assessment was done at 1 month, 3, 6 and 12 months after the surgery in which patients were assessed using Star excursion balance test by measuring excursion distances in each of the 8 directions.

Results: Excursion distances in eight directions showed less increment inACL+MM  group with  compared to ACL group. However it was found to be statistically significant only for posteromedial, lateral and medial directions.

Conclusion: Concomitant menisectomy does affect the recovery of dynamic proprioceptive deficits and the recovery phase is longer after arthroscopically assisted anterior cruciate ligament (ACL) reconstruction compared to ACL reconstruction alone.

Key words: Star excursion balance test, Anterior cruciate ligament, Dynamic proprioception, Postural Stability.


  1. Noyes, F. R.; Grood, E. S.;Butler, D. L. Clinical laxity tests and functional stability of the knee: biomechanical concepts. ClinOrthop 1980;146:84-89.
  2. Henriksson M, Ledin T, Good L. Postural control after anterior cruciate ligamentreconstruction and functional rehabilitation. Am J Sports Med 2001;29:359– 66.
  3. Riemann BL, Lephart SM. The sensorimotor system, part I: the physiologic basisof functional joint stability. J Athl Train 2002;37:71–9.
  4. Edwards, A.; Bull, A.; Amis , A. The attachments of the anteromedial and posterolateral fibre bundles of the anterior cruciate ligament: part 2: femoral attachment. Knee Surg Sports Traumatol Arthros 2008;16:29-36.
  5. Peterson,W.;Zantop,T. Anatomy of anterior cruciate ligament with regard to its two bundles. Clin Orthop Relat Res 2007;454:35-47.
  6. Limbird TJ, Shiavi R, Frazer M, Borra. HEMG profiles of knee joint musculature during walking: changes induced by anterior cruciate ligament deficiency. J Orthop Res. 1988; 6(5):630-8.
  7. Brindle T, Nyland J, Johnson DL. The meniscus: review of basic principles with application to surgery and rehabilitation. J Athl Train 2001;36:160–169.
  8. Aagaard H, Verdonk R. Function of the normal meniscus and consequences of meniscal resection. Scand J Med Sci Sports 1999;9:134–140.
  9. Ahmed MM, Mosalem DM, Khairet SM, Ismail TA, Hamido FA, Al-Busairi WA. Evaluation of dynamic posturography in anterior cruciate ligament injurypatients. Maced J Med Sci 2011;15:167–73.
  10. Cho SR, Kim HM, Lee KH, Kim YS, Lee JH, Jahng YJ. The change of the mechanore-ceptor of anterior cruciate ligament in fixed knee and injured anterior cruciateligament in the rabbit. J Korean Orthop 2004;39:572–8.
  11. Kanemura N, Kobayashi R, Kajihara H, Minematu A, Sasaki H, Tanaka S, et al. Changes of mechanoreceptor in anterior cruciate ligament with hindlimb sus-pension rats. J Phys Ther Sci 2002;14:27–32.
  12. Rymer T, Kruczy´nski J. Knee joint proprioception evaluation with own con-struction device. Chir Narzadow Ruchu Ortop Pol 2007;72:189–92.
  13. Dhillon MS, Bali K, Prabhakar S. Proprioception in anterior cruciate ligamentdeficient knees and its relevance in anterior cruciate ligament reconstruction.Indian J Orthop 2011;45:294–300.
  14. Pasierbi´nski A, Jarz˛abek A. Rehabilitation after anterior cruciate ligamentreconstruction. Acta Clinica 2002;2:86–100.
  15. Karahan M, Kocaoglu B, Cabukoglu C, Akgun U, Nuran R. Effect of partial medial meniscectomy on the proprioceptive function of the knee. Arch Orthop Trauma Surg 2010;130:427–431.
  16. Thijs Y, Witvrouw E, Evens B, Coorevits P, Almqvist F, Verdonk R. A prospective study on knee proprioception after meniscal allograft transplantation. Scand J Med Sci Sports 2007;17:223–229.
  17. Lange AK, Singh F, Smith RM, Foroughi N, Baker MK, Shnier R, Vanwanseele B. Degenerative meniscus tears and mobility impairment in women with knee osteoarthritis. Osteoarthr Cartil 2007;15:701–708.
  18. Palm HG, Laufer C, von Lu¨bken F, Achatz G, Friemert B. Do meniscus injuries affect postural stability? Der Orthopade 2010;39:486–494.
  19. Gribble, PA., Hertel, J., and Plisky, P. Using the Star Excursion Balance Test to assess dynamic postural-control deficits and outcomes in lower extremity injury: a literature and systematic review. Journal of Athletic Training, 2012;47:339-357.
  20. Earl, J., and Hertel, J. Lower-extremity muscle activation during the Star Excursion Balance Tests. Journal of Sports Rehabilitation 2001;10:93–104.
  21. Kennedy JC, Alexander IJ, Hayes KC. Nerve supply of the human knee and its functional importance. Am J Sports Med 1982;10:329–335.
  22. Al-Dadah O, Shepstone L, Donell ST. Proprioception following partial meniscectomy in stable knees. Knee Surg Sports Traumatol Arthrosc 2011;19:207–213.
  23. Wang JH, Wong AK, Romanowski JR 2nd, Fu FH. Meniscus tear developed by pulling of the anomalous insertion of medial meniscus on anterior cruciate ligament. Knee Surg Sports Traumatol Arthrosc 2011;19:1689–1692.
  24. Shelbourne KD, Nitz PA. The O’Donoghue triad revisited. Combined knee injuries involving anterior cruciate and medial collateral ligament tears. Am J Sports Med 1991;19:474–477.

Cite this article: Atul Mahajan, Anil Mehtani. EFFECT OF MENISECTOMY ON RECOVERY OF PROPRIOCEPTIVE DEFICITS FOLLOWING ARTHROSCOPIC ACL RECONSTRUCTION. Int J Physiother Res 2017;5(4):2225-2231. DOI: 10.16965/ijpr.2017.178