Gait mechanics 2 years after anterior cruciate ligament reconstruction are associated with longer‐term changes in patient‐reported outcomes. Issue 3 (15th June 2016)

• Record Type: Journal Article
• Authors: Erhart‐Hledik, Jennifer C.; Chu, Constance R.; Asay, Jessica L.; Andriacchi, Thomas P.
• Other Names: Rodeo Scott guestEditor.; Buckwalter Joseph A. guestEditor.; Lotz Martin guestEditor.
• Is Part Of: Journal of orthopaedic research. Volume 35:Issue 3(2017)
• Page Start: 634
• Page End: 640
• Publication Date: 2016-06-15
• Subjects: ACL -- reconstruction -- patient‐reported outcome -- gait analysis -- knee; Orthopedics -- Periodicals; Musculoskeletal system -- Periodicals; 616.7
• DOI: 10.1002/jor.23317
• Languages: English
• ISSNs: 0736-0266

Abstract

ABSTRACT: This study tested the hypothesis that side‐to‐side differences in knee gait mechanics 2 years after anterior cruciate ligament (ACL) reconstruction are associated with long‐term (∼8 years post‐reconstruction) changes in patient‐reported outcome scores. Sixteen subjects (5 males; age: 29.1 ± 7.1 years) with primary unilateral ACL reconstruction were gait tested at baseline (2.2 ± 0.3 years post‐ACL reconstruction) and filled out KOOS and Lysholm surveys. At long‐term follow‐up (7.7 ± 0.7 years post‐ACL reconstruction), the same subjects completed KOOS and Lysholm surveys. Pearson correlation coefficients assessed relationships between side‐to‐side differences in kinematics and kinetics at baseline and changes in Lysholm and KOOS Pain/QOL scores from 2 to 8 years post‐ACL reconstruction. Significant associations were seen between greater average varus rotation (Lysholm: R = −0.654, p = 0.006) and less anterior femoral displacement (Lysholm: R = 0.578, p = 0.019) during stance of the ACL reconstructed knee versus the contralateral knee at baseline and worse follow‐up outcome scores. Significant associations were seen between greater peak knee flexion moment (KOOS Pain: R = −0.572, p = 0.026; KOOS QOL: R = −0.636, p = 0.011), peak knee adduction moment (Lysholm: R = −0.582, p = 0.018; KOOS Pain: R = −0.742, p = 0.002; KOOS QOL: R = −0.551, p = 0.033), and peak internal rotation moment (Lysholm: R = 0.525, p = 0.037; KOOS Pain: R = 0.815, p < 0.001; KOOS QOL: R = 0.777, p = 0.001) in the ACL reconstructed knee at baseline with worse follow‐up outcomes. The results of this study support the hypotheses that early changes in gait mechanics following ACL reconstruction are associated with longer‐term clinical changes in patient‐reported outcomes, suggesting that biomechanical markers obtained as early as 2 years after ACL reconstruction may be useful to understand clinical outcomes in this population. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:634–640, 2017.