THE CURRENT APPROACH TO RESTORING KNEE STABILITY THROUGH THE KNEE SYMMETRY MODEL: LITERATURE REVIEW
THE CURRENT APPROACH TO RESTORING KNEE STABILITY THROUGH THE KNEE SYMMETRY MODEL: LITERATURE REVIEW

Summary/Abstract: The main objectives of anterior cruciate ligament reconstruction (ACLR) are to maximize stability and functional capacity, while enabling a safe return to sports activity. The aim of this study was to conduct a literature review focused on the objectification of the Knee Symmetry Model (KMS) program in restoring stability and motor control of the knee following ACL surgery, using the Limb Symmetry Index (LSI). The purpose of KMS is to restore symmetry in the affected limb in terms of range of motion (ROM), strength, and function compared to the contralateral limb. The literature review included 200 articles selected based on eligibility criteria, through searches of databases such as PubMed, Medline, Web of Science, Cochrane Library, Embase, etc., encompassing randomized controlled trials and cohort studies. The principal outcome of the review indicated that restoration of hamstring strength symmetry remains suboptimal up to one year following anterior cruciate ligament (ACL) reconstruction, with values frequently falling below the 90% limb symmetry index (LSI) threshold typically used to define successful recovery. Although it is theoretically plausible that achieving an LSI of ≥90% in hamstring strength may confer a protective benefit given the hamstrings’ role as synergistic stabilizers of the ACL-only four of the studies included in the review reported disaggregated hamstring strength data for individuals who sustained a subsequent ACL injury. The conclusion of the study is that the use of LSI, in the context of applying the KMS, may allow for effective monitoring of the progression of stability and functional symmetry in the operated ACL knee.

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