Altered tibiofemoral kinematics in the affected knee and compensatory changes in the contralateral knee after anterior cruciate ligament reconstruction

Marcus Hofbauer, Eric D Thorhauer, Ermias Abebe, Michael Bey, Scott Tashman
American Journal of Sports Medicine 2014, 42 (11): 2715-21

BACKGROUND: Previous studies of knee kinematics after anterior cruciate ligament (ACL) reconstruction have generally employed low-effort tasks and typically not assessed changes in kinematics over time.

HYPOTHESES: (1) During single-legged hop landing, ACL-reconstructed limbs will have altered kinematics compared with contralateral (ACL-intact) limbs 5 months after surgery. (2) Kinematic differences between limbs will decrease over time because of changes in both ACL-reconstructed and ACL-intact limbs.

STUDY DESIGN: Controlled laboratory study.

METHODS: In vivo kinematics of ACL-reconstructed and contralateral ACL-intact knees were evaluated for 14 subjects during single-legged forward-hop landings at 5 and 12 months after surgery on the basis of dynamic stereo x-ray imaging. Differences between limbs and changes over time were assessed via repeated-measures analysis of variance.

RESULTS: Five months after surgery, ACL-reconstructed knees landed significantly less flexed compared with contralateral ACL-intact knees (20.9° vs 28.4°, respectively; P < .05). The ACL-reconstructed knees were significantly more externally rotated (12.2° vs 6.5°; P < .05) and medially translated (3.8 vs 2.3 mm; P < .009) compared with ACL-intact knees. Anterior-posterior translation was similar between limbs. From 5 to 12 months, knee flexion at landing increased in ACL-reconstructed knees (mean change, +3.4°; P < .05) and decreased in contralateral knees (mean change, -3.3°; P < .05). External tibial rotation also significantly decreased in ACL-reconstructed knees (-2.2°; P < .05) and increased in contralateral knees (+1.1°; P = .117) over time. Medial tibial translation decreased slightly over time only in ACL-reconstructed knees (-0.3 mm).

CONCLUSION: Five months after ACL reconstruction, landing kinematics differed between ACL-reconstructed and contralateral ACL-intact knees during a dynamic high-loading activity. These differences decreased over time, owing to changes in both the ACL-reconstructed and contralateral ACL-intact limbs.

CLINICAL RELEVANCE: This study identified kinematic changes over time in both the ACL-injured and contralateral ACL-intact knees after ACL reconstruction. These kinematic adaptations could have important implications for postoperative care, including evaluating the optimal timing of return to sports and the development of bilateral neuromuscular rehabilitation programs that may improve patient outcomes and reduce reinjuries in both the short and long terms.

Full Text Links

Find Full Text Links for this Article


You are not logged in. Sign Up or Log In to join the discussion.

Related Papers

Remove bar
Read by QxMD icon Read

Save your favorite articles in one place with a free QxMD account.


Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"