{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T07:11:37Z","timestamp":1781766697783,"version":"3.54.5"},"reference-count":48,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2023,2,9]],"date-time":"2023-02-09T00:00:00Z","timestamp":1675900800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>(1) Background: Optimal neuromuscular, Lumbo-Pelvic-Hip Complex, and lower extremity control are associated with decreased risk factors for secondary anterior cruciate ligament (ACL) injury. This study aimed to analyze any asymmetries and malalignments in the Lumbo-Pelvic-Hip Complex and the lower limbs at 6 months after ACL reconstruction (ACLR). (2) Methods: We conducted an exploratory retrospective observational single-center study in patients during the outpatient postoperative rehabilitation program at ICOT (Latina, Italy). From January 2014 to June 2020, 181 patients were recruited, but only 100 patients (86 male 28 \u00b1 0.6 years, 178 \u00b1 0.5 height; 14 female 24 \u00b1 2.0 years, 178 \u00b1 3.0 height) were eligible for the inclusion criteria and studied 6 months after ACL reconstruction surgery. (3) Statistical analysis: Student\u2019s t-tests and Pearson\u2019s product-moment correlation coefficient were used to determine significant differences between affected and non-affected limbs and variables\u2019 association. (4) Results: The study shows a decrease in neuromuscular control of the Lumbo-Pelvic-Hip Complex and dynamic adaptive valgus of the knee at 6 months after ACLR (mean difference between pathological and healthy limb of dynamic adaptive valgus was \u221210.11 \u00b1 8.19\u00b0 95% CI \u221214.84 to \u22129.34; mean value was 16.3 \u00b1 6.8\u00b0 95% CI 14.04 to 18.55 for healthy limb and 4.2 \u00b1 3.1\u00b0 95% CI 3.15 to 5.21 for pathological limb, p &lt; 0.0001). The results also showed a relationship between dynamic adaptive valgus and contralateral pelvic drop (r = 0.78, 95% CI 0.62 to 0.88, magnitude of correlation very large). (5) Conclusions: The analysis showed an associative correlation between decreased postural control of the pelvic girdle and dynamic adaptive valgus of the knee in 38% of patients; this study highlights the usefulness of the Single-Leg Squat Test (SLST) as a clinical\/functional assessment to evaluate the rehabilitation process and as a preventive tool to reduce the risk of second ACL injuries during the return to sport.<\/jats:p>","DOI":"10.3390\/ijerph20043063","type":"journal-article","created":{"date-parts":[[2023,2,10]],"date-time":"2023-02-10T02:33:27Z","timestamp":1675996407000},"page":"3063","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Prevention of Secondary Injury after Anterior Cruciate Ligament Reconstruction: Relationship between Pelvic-Drop and Dynamic Knee Valgus"],"prefix":"10.3390","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8995-3072","authenticated-orcid":false,"given":"Rosario","family":"D\u2019Onofrio","sequence":"first","affiliation":[{"name":"Member of the Medical-Scientific Multidisciplinary Commission, Italian Football Doctors Association-L.A.M.I.CA., 04023 Formia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3066-3943","authenticated-orcid":false,"given":"Anas Radi","family":"Alashram","sequence":"additional","affiliation":[{"name":"Department of Physiotherapy, Faculty of Allied Medical Science, Middle East University, Amman 11622, Jordan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Annino","sequence":"additional","affiliation":[{"name":"Centre of Space Bio-Medicine, Department of Medicine Systems, University of Rome \u201cTor Vergata\u201d, 00133 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matteo","family":"Masucci","sequence":"additional","affiliation":[{"name":"Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, ON N2L 3G1, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0904-634X","authenticated-orcid":false,"given":"Cristian","family":"Romagnoli","sequence":"additional","affiliation":[{"name":"Sport Engineering Lab, Department Industrial Engineering, University of Rome \u201cTor Vergata\u201d, 00133 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5227-2567","authenticated-orcid":false,"given":"Elvira","family":"Padua","sequence":"additional","affiliation":[{"name":"Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, 00166 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincenzo","family":"Manzi","sequence":"additional","affiliation":[{"name":"Department of Humanities Science, Pegaso Open University, 80143 Naples, Italy"},{"name":"Hellas Verona Football Club, Via Olanda 11, 37135 Verona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,2,9]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1177\/0363546511422999","article-title":"Return-to-sport outcomes at 2 to 7 years after Anterior Cruciate Ligament Reconstruction surgery","volume":"40","author":"Ardern","year":"2011","journal-title":"Am. 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