Gait knee kinematics after ACL reconstruction: 3D assessment
Résumé
PURPOSE: While many studies about anterior-cruciate-ligament-deficient (ACLD) patients have demonstrated functional adaptations to protect the knee joint, an increasing number of patients undergo ACL reconstruction (ACLR) surgery in order to return to their desired level of activity. The purpose of this study was to compare 3D kinematic patterns between individuals having undergone ACLR with their healthy contralateral knee and a control group. METHODS: Three-dimensional kinematic data were obtained from 15 patients pre- and post-ACLR, 15 contralateral knees and 15 healthy controls. Data were recorded during treadmill walking at self-selected speed. Flexion/extension, external/internal tibial rotation, adduction/abduction and anterior/posterior tibial translation were compared between groups. RESULTS: ACLR knees showed a significantly higher knee-joint extension during the entire stance phase compared with ACLD knees. However, ACLR knees still showed a deficit of extension compared with healthy control knees. In the axial plane, there was no significant difference in pre- and postoperative kinematic data. Significant difference was achieved between ACLR knees and healthy control knees, specifically between 28 and 34 % and 44 and 54 % of the gait cycle. There was no significant difference in anterior-posterior translation or coronal plane between groups. CONLUSION: Following ACL reconstruction, patients have better clinical and kinematic parameters. Despite improvements, knee kinematics during gait in the ACLR group differed from the control group. These kinematic changes could lead to abnormal loading in the knee joint and initiate the process for future chondral degeneration.