Knee joint biomechanics during gait improve from 3 to 6 months after anterior cruciate ligament reconstruction

Neal, Kelsey; Williams, Jack R.; Alfayyadh, Abdulmajeed; Capin, Jacob J.; Khandha, Ashutosh; Manal, Kurt; Snyder-Mackler, Lynn; Buchanan, Thomas S.

Affiliations

¹Department of Mechanical Engineering, University of Delaware, Newark, Delaware, USA

²Biomechanics and Movement Science, University of Delaware, Newark, Delaware, USA

³Department of Physical Therapy, University of Delaware, Newark, Delaware, USA

⁴Department of Physical Medicine and Rehabilitation, Physical Therapy Program, University of Colorado, Aurora, Colorado, USA

⁵Eastern Colorado VA Geriatric Research Education and Clinical Center (GRECC), Aurora, Colorado, USA

⁶Department of Physical Therapy, Marquette University, Milwaukee, Wisconsin, USA

⁷Department of Biomedical Engineering, University of Delaware, Newark, Delaware, USA

⁸Department of Kinesiology and Applied Physiology, University of Delaware, Newark, Delaware, USA

Abstract and keywords

Gait alterations after anterior cruciate ligament reconstruction (ACLR) are commonly reported and have been linked to posttraumatic osteoarthritis development. While knee gait alterations have been studied at several time points after ACLR, little is known about how these biomechanical variables change earlier than 6 months after surgery, nor is much known about how they differ over the entire stance phase of gait. The purpose of this study was to examine knee gait biomechanical variables over their entire movement pattern through stance at both 3 and 6 months after ACLR and to study the progression of interlimb asymmetry between the two postoperative time points. Thirty-five individuals underwent motion analysis during overground walking 3 (3.2 ± 0.5) and 6 (6.4 ± 0.7) months after ACLR. Knee biomechanical variables were compared between limbs and across time points through 100% of stance using statistical parametric mapping; this included a 2 × 2 (Limb × Time) repeated measures analysis of variance and two-tailed t-tests. Smaller knee joint angles, moments, extensor forces, and medial compartment forces were present in the involved versus uninvolved limb. Interlimb asymmetries were present at both time points but were less prevalent at 6 months. The uninvolved limb's biomechanical variables stayed relatively consistent over time, while the involved limb's trended toward that of the uninvolved limb. Statement of Clinical Significance: Interventions to correct asymmetrical gait patterns after ACLR may need to occur early after surgery and may need to focus on multiple parts of stance phase.

Keywords: ACLR; gait biomechanics; kinematics and kinetics; knee; statistical parametric mapping

Links

DOI: 10.1002/jor.25250

PubMed: 34989019

WoS: 000739333400001

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