Anterior cruciate ligament injury alters preinjury lower extremity biomechanics in the injured and uninjured leg: the JUMP-ACL study

Goerger, Benjamin M.; Marshall, Stephen W.; Beutler, Anthony I.; Blackburn, J. Troy; Wilckens, John H.; Padua, Darin A.

doi:10.1136/bjsports-2013-092982

Cited by 100 publications

(95 citation statements)

References 41 publications

(40 reference statements)

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“…Asymmetries in loading and movement patterns between limbs can be present up to 2 years after reconstruction contributing to increased risk for ACL re‐injury to both the surgical and non‐surgical limb . ACLR patients have a tendency to land with increased knee abduction moments and knee extension, as well as decreased peak knee flexion moments, and vertical ground reaction forces .…”

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confidence: 99%

Limb asymmetry during recovery from anterior cruciate ligament reconstruction

Renner

Franck

Miller

et al. 2018

Journal Orthopaedic Research

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There is limited literature that follows a population of Anterior Cruciate Ligament Reconstruction (ACLR) patients through recovery. Our aim was to examine differences in movement and loading patterns across time and between limbs over four visits during 12 months post-ACLR. We hypothesized that kinematic and kinetic data during a stop-jump would have time- and limb-dependent differences through 12 months post-surgery. Twenty-three ACLR athletes performed five vertical stop-jumps at 4, 5, 6, and 12 months post-op with motion capture and force plate data collection. The peak knee flexion (PKF) was different between the 4 and 12, 5 and 6, and the 5 and 12 month visits with earlier months exhibiting higher PKF. The peak vertical ground reaction force (vGRF) was lower at 4 than at 5 and 6 months. The peak posterior ground reaction force (pGRF) was lower at 4 months than all other visits. Frontal knee and sagittal hip range of motion (ROM) were different between 12 months and each previous visit. Asymmetries were present in peak vGRF, peak knee extension moment and impulse up to 12 months. The loading rate and peak pGRF demonstrated between limb differences up to 6 months; limb stiffness demonstrated differences up to 5 months post-ACLR. PKF was only asymmetric at the 4 month visit. While some variables improved in the 12 months post-ACLR, limb asymmetries in peak knee extension moment, peak vGRF and impulse persisted up to 12 months. Additionally, frontal plane knee and sagittal hip ROM had not normalized at 12 months. © 2018 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 36:1887-1893, 2018.

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confidence: 99%

Limb asymmetry during recovery from anterior cruciate ligament reconstruction

Renner

Franck

Miller

et al. 2018

Journal Orthopaedic Research

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“…There is a lack of consistency in the literature regarding leg dominance as an etiological factor for non‐contact anterior cruciate ligament injuries, with injury rates for the non‐dominant leg (often defined as the non‐kicking leg) ranging from 43% to 67% (Matava et al., ; Negrete & Schick, ; Brophy et al., ; Goerger et al., ). Clinically, it is important to understand if leg dominance is an etiological factor for ACL tears, as this would lead to further development of targeted interventions to address asymmetries between legs.…”

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confidence: 99%

Biomechanical differences related to leg dominance were not found during a cutting task

Greska

Cortés

Ringleb

et al. 2016

Scandinavian Med Sci Sports

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Previous studies have shown conflicting information regarding leg dominance as an etiological factor for the risk of anterior cruciate ligament (ACL) injuries. It remains unclear if lower extremity neuromechanical limb asymmetries exist in experienced athletes. The purpose of this study was to evaluate lower extremity neuromechanical effects of leg dominance in female collegiate soccer athletes during an unanticipated side-step cutting task. Twenty female collegiate soccer players completed an unanticipated side-step cutting task, using their dominant and non-dominant legs. Kinematic and kinetic data were collected to quantify joint angles and forces, with wireless electromyography (EMG) quantifying muscle activity. MANOVA's were conducted to determine the effect of leg dominance on hip and knee mechanics at and between pre-contact, initial contact, peak knee adduction moment, and peak stance periods. Dependent variables consisted of peak time occurrences, hip and knee rotations and moments, ground reaction force, EMG amplitudes, stance time, and approach velocity. No significant differences were found for any variables at or between the periods of interest. Collegiate female soccer athletes exhibit similar movement patterns between dominant and non-dominant legs while performing a side-step cutting task, suggesting that leg dominance does not adversely influence known biomechanical non-contact ACL risk factors.

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“…A history of knee injury could be related to bilaterally altered biomechanics (36–39) or neuromuscular control (40–42), that predisposes the ipsilateral or contralateral knee to a new injury. For example, individuals with a history of an ACL injury have altered biomechanics and neuromuscular control in the injured and uninjured knees, both of which could predispose the knees to a future ACL injury (38, 40). This may explain why an injury in either knee could increase the risk of a new injury.…”

Section: Discussionmentioning

confidence: 99%

Knee Pain and a Prior Injury Are Associated with Increased Risk of a New Knee Injury: Data from the Osteoarthritis Initiative

Driban

Lo²,

Eaton³

et al. 2015

J Rheumatol

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Objectives We explored if knee pain or a history of knee injury was associated with a knee injury in the following 12 months. Methods We conducted longitudinal knee-based analyses among knees in the Osteoarthritis Initiative. We included both knees of all participants who had at least one follow-up visit with complete data. Our first sets of exposures were knee pain (chronic knee symptoms and severity) at baseline, 12-month, 24-month, and 36-month visits. Another exposure was a history of injury, which we defined as a self-reported injury at any time prior to baseline, 12-month, 24-month, or 36-month visits. The outcome was self-reported knee injury during the past year at 12-month, 24-month, 36-month, and 48-month visits. We evaluated the association between ipsilateral and contralateral knee pain or history of injury and a new knee injury within 12 months of the exposure using generalized linear mixed model for repeated binary outcomes. Results A knee with reported chronic knee symptoms or ipsilateral or contralateral history of an injury was more likely to experience a new knee injury in the following 12 months than a knee without chronic knee symptoms (odds ratio [OR]=1.84, 95% confidence interval [CI]=1.57, 2.16) or prior injury (prior ipsilateral knee injury OR=1.81, 95% CI=1.56, 2.09; prior contralateral knee injury OR=1.43, 95% CI=1.23, 1.66). Conclusion Knee pain and a history of injury are associated with new knee injuries. It may be beneficial for individuals with knee pain or a history of injury to participate in injury prevention programs.

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Anterior cruciate ligament injury alters preinjury lower extremity biomechanics in the injured and uninjured leg: the JUMP-ACL study

Abstract: ACL injury and ACLR caused movement pattern alterations of the injured and uninjured leg that have previously shown to increase the risk for future non-contact ACL injury.

Cited by 100 publications

References 41 publications

Limb asymmetry during recovery from anterior cruciate ligament reconstruction

Limb asymmetry during recovery from anterior cruciate ligament reconstruction

Biomechanical differences related to leg dominance were not found during a cutting task

Knee Pain and a Prior Injury Are Associated with Increased Risk of a New Knee Injury: Data from the Osteoarthritis Initiative

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