Tibiofemoral joint kinematics of the anterior cruciate ligament-reconstructed knee during a single-legged hop landing

Jessica M Deneweth, Michael J Bey, Scott G McLean, Terrence R Lock, Patricia A Kolowich, Scott Tashman
American Journal of Sports Medicine 2010, 38 (9): 1820-8

BACKGROUND: Abnormal 3-dimensional tibiofemoral joint kinematics have been identified in anterior cruciate ligament-reconstructed knees during functional gait tasks, which is suggested to directly affect risk of knee osteoarthritis. However, the extent to which similar high-risk abnormalities are present during more demanding maneuvers, such as single-legged hopping, is largely unknown.

HYPOTHESIS: When performing a single-legged forward hop landing, the reconstructed knee will demonstrate altered sagittal, frontal, and transverse plane kinematics compared with the contralateral limb.

STUDY DESIGN: Controlled laboratory study.

METHODS: High-speed biplane radiography was used to quantify bilateral 3-dimensional tibiofemoral joint kinematics in 9 subjects with unilaterally reconstructed anterior cruciate ligaments (mean time after surgery, 4 months) during 3 single-legged, forward hop landing trials. Mean subject-based initial foot contact and maximum stance (0-250 ms) values were calculated for each kinematic variable. Two-tailed paired t tests were subsequently applied to examine for the main effect of limb (reconstructed vs contralateral).

RESULTS: The reconstructed knees exhibited significantly greater extension (P = .04), external tibial rotation (P = .006), and medial tibial translation (P = .02) than the contralateral knees at initial contact. Reconstructed knees underwent significantly greater maximum flexion (P = .05), maximum external tibial rotation (P = .01), and maximum anterior tibial translation (P = .02). No significant differences existed between limbs for initial contact (P = .65) or maximum adduction-abduction (P = .55).

CONCLUSION: Tibiofemoral joint kinematics of the anterior cruciate ligament-reconstructed knee are significantly different from those of the uninjured contralateral limb during a single-legged hop landing. This altered kinematic profile, in conjunction with the large impact loads associated with hopping, may further contribute to the risk of posttraumatic knee osteoarthritis.

CLINICAL RELEVANCE: Returning to sports involving dynamic single-legged landings at 4 months after anterior cruciate ligament reconstruction surgery may contribute to accelerated knee joint degeneration.

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