The aim of this study is to determine how selected gait parameters may change as a result of anterior cruciate ligament (ACL) deficiency and following ACL reconstruction. The study was performed on 25 ACL-deficient subjects prior to and 6 weeks, 4 months, 8 months and 12 months after ACL reconstructive surgery by the bone-patellar tendon-bone technique. Gait analysis was performed using the zebris three-dimensional ultrasound-based system with surface electromyograph (zebris Medizintechnik GmbH, Germany). Kinematic data were recorded for the lower limb. The muscles examined include vastus lateralis and medialis, biceps femoris and adductor longus. The results obtained from the injured subjects were compared with those of 51 individuals without ACL damage. The acute ACL-deficient patients exhibited a quadriceps avoidance pattern prior to and 6 weeks after surgery. The quadriceps avoidance phenomenon does not develop in chronic ACL-deficient patients. In the individuals operated on, the spatial-temporal parameters and the knee angle had already regained a normal pattern for the ACL-deficient limb during gait 4 months after surgery. However, the relative ACL movement parameter-which describes the tibial translation into the direction of ACL-and the EMG traces show no significant statistical difference compared with the values of healthy control group just 8 months after surgery. The results suggest that: (1) development of a quadriceps avoidance pattern is less common than previously reported, (2) anterior cruciate ligament deficiency and reconstruction significantly alter the lower extremity gait pattern, (3) the gait parameters shift towards the normal value pattern, and (4) the re-establishment of pre-injury gait patterns--including the normal biphase of muscles--takes at least 8 months to occur.
The aim of this study is to determine how selected gait parameters may change as a result of medial meniscectomy at constant gait speed. Gait analysis using a ZEBRIS ultrasound based three-dimensional motion analysis system was performed in 24 patients who had undergone medial meniscectomy 18 months before the gait analysis. The constant gait speed was 3.5 km/h. Muscle activity was measured by the surface EMG system connected to the system. The muscle groups involved in the tests included (1) m. vastus medialis and (2) lateralis, (3) rectus femoris, (4) m. biceps femoris, (4) m. adductor longus, (5) m. gluteus medius, (6) m. gastrocnemius medialis and (7) lateralis. The spatial-temporal, angular parameters and intermuscular coordination determined are compared to the gait parameters of 51 healthy subjects. The study showed that medial meniscectomy resulted in a change of limb dominance; reduced knee joint motion was compensated by the increased motion of other joints in the kinematic chain-hip joint of the opposite side, pelvic obliquity-and the gait (spatial-temporal parameters) was symmetrical, with no significant differences compared to spatial-temporal parameters of healthy groups. Our study showed that the medial meniscectomy could result in adductor-free gait and reduce the rotation motion of the pelvis.
The complexity of gait decreased if the walking speed differed from the self-selected speed. Prior to and after meniscectomy, the decreased variability of angular parameters on the affected side of patients represented decreased flexibility of joints. This led to decreased consistency in movements of the lower limbs from stride to stride, as shown by the increased variability of spatial-temporal parameters. A decrease in joint flexibility and consistency of movement can be associated with a decreased complexity of movement. Preoperatively and postoperatively, patients used the non-affected limb and pelvis obliquity for compensation to help stabilize their gait.
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