Kinematic and kinetic gait deviations in males long after anterior cruciate ligament reconstruction. (November 2017)

• Record Type: Journal Article
• Authors: Milandri, Giovanni; Posthumus, Mike; Small, T.J.; Bothma, Adam; van der Merwe, Willem; Kassanjee, Reshma; Sivarasu, Sudesh
• Is Part Of: Clinical biomechanics. Volume 49(2017)
• Page Start: 78
• Page End: 84
• Publication Date: 2017-11
• Subjects: Ground reaction force -- Knee varus -- Knee valgus -- Abduction -- Adduction -- Gait; Biomechanics -- Periodicals; Osteopathic medicine -- Periodicals; Biomechanics -- Periodicals; Osteopathic Medicine -- Periodicals; 612.76
• DOI: 10.1016/j.clinbiomech.2017.07.012
• Languages: English
• ISSNs: 0268-0033

Abstract

Abstract: Background: Biomechanical deviations long (approx. 5 years) after anterior cruciate ligament reconstruction have not been quantified in males, despite their distinct risk profile as compared to females. These deviations can indicate altered joint loading during chronic, repetitive motions. Methods: Cross-sectional study, comparing kinematic and kinetic variables between 15 male anterior cruciate ligament reconstructed patients and 15 healthy controls. During walking and running gait, measurements were taken of impact dynamics, knee and hip sagittal plane angles and moments, and knee varus angles and adduction moments. Findings: Comparing affected limbs to control limbs, significantly lower maximum ( P = 0.001) and initial ( P = 0.003) loading rates were found during running, but not in walking. Hip angles were lower for affected limbs of patients compared to the control group ( P = 0.039) in walking, but not during running. Between-limb comparisons showed important differences in symmetry of the affected patients. Maximum force during running was higher in the unaffected limb ( P = 0.015), which was linked with a higher loading rate ( P = 0.008). Knee flexion angle was reduced by 2° on average for the affected limb during running ( P = 0.010), and both walking and running knee and hip moments showed differences. Knee varus angle showed a 1° difference during walking ( P < 0.001), but not during running. Knee adduction moment was significantly lower (more valgus) during both walking and running. Interpretation: Male anterior cruciate ligament reconstructed patients demonstrate persistent, clinically important gait asymmetries and differences from healthy controls long after surgery in kinematics, kinetics, and impact biomechanics. Highlights: Anterior cruciate ligament reconstructed females show persistent gait deviations. No previous research has investigated these during walking/running in male patients. Knee adduction moments and angles were lower in affected than unaffected limbs. Reduced knee flexion angles and moments were also found, but only during running. Deviations from controls were also found in impact during foot strike.