An Assessment of Tibiofemoral Kinematics Amd Kinetics Following Anterior Cruciate Ligament Reconstruction

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Abstract

The anterior cruciate ligament (ACL) is the most commonly injured knee ligament with approximately 250,000 ACL tears diagnosed each year in the United States which leads to an estimated 150,000 ACL reconstructions annually. The primary goal of ACL reconstruction is to restore stability to the knee and return the patient to their prior level of activity. However, it has been reported that abnormal motion and/or forces at the knee due to ACL reconstruction could lead to early-onset knee osteoarthritis. It is hypothesized that alterations in knee joint kinematic and kinetic measurements after ACL reconstruction can be characterized when compared to a control population. The current work describes how the ACL reconstruction subjects’ three-dimensional knee joint angles and moments during gait were compared to control subjects, and it explores the knee kinematics and ground reaction forces during a squat activity. This work also discusses the theory behind musculoskeletal modeling and applies an advanced model to examine the tibiofemoral compressive forces and predicted muscle forces during gait of the ACL reconstruction subjects compared to BMI-matched control subjects. These studies showed the capabilities of using musculoskeletal modeling along with principal component analysis to identify ACL reconstruction subjects who displayed knee kinematic and kinetic measurements which fell outside of normal values. This type of analysis may lead to a diagnostic tool for detecting individuals at risk for developing early osteoarthritis after ACL reconstruction. This would allow these individuals to receive early intervention in the hopes of mitigating knee osteoarthritis.

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