Biomechanical Factors Associated With Pain and Symptoms Following Anterior Cruciate Ligament Injury and Reconstruction

Azus, A.; Teng, Hsiang‐Ling; Tufts, Lauren; Wu, Daniel S.; Benjamin, C.; Souza, Richard B.; Li, Xiaojuan

doi:10.1016/j.pmrj.2017.05.004

Cited by 11 publications

(17 citation statements)

References 37 publications

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“…Similarly, lower peak vGRF in the ACLR limb is associated with higher concentrations of type‐II collagen turnover approximately 3 years following ACLR ( ρ = 0.59) . Furthermore, lower peak vGRF impulse during the second half of the stance phase of gait following ACL injury, but prior to ACLR, is associated with greater self‐reported knee related symptoms collected at 6 months following ACLR ( r = 0.38) . Overall, these data indicate that vGRF characteristics‐related outcome measures collected during gait are linked to negative metabolic joint tissue changes and poor self‐reported knee symptoms .…”

mentioning

confidence: 80%

Walking gait asymmetries 6 months following anterior cruciate ligament reconstruction predict 12‐month patient‐reported outcomes

Pietrosimone

Blackburn

Padua

et al. 2018

Journal Orthopaedic Research

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The study sought to determine the association between gait biomechanics (vertical ground reaction force [vGRF], vGRF loading rate [vGRF-LR]) collected 6 months following anterior cruciate ligament reconstruction (ACLR) with patient-reported outcomes at 12 months following ACLR. Walking gait biomechanics and all subsections of the Knee Injury and Osteoarthritis Outcomes Score (KOOS) were collected at 6 and 12 months following ACLR, respectively, in 25 individuals with a unilateral ACLR. Peak vGRF and peak instantaneous vGRF-LR were extracted from the first 50% of the stance phase. Limb symmetry indices (LSI) were used to normalize outcomes in the ACLR limb to that of the uninjured limb (ACLR/uninjured). Linear regression analyses were used to determine associations between biomechanical outcomes and KOOS while accounting for walking speed. Receiver operator characteristic curves were used to determine the accuracy of 6-month biomechanical outcomes for identifying individuals with acceptable patient-reported outcomes, using previously defined KOOS cut-off scores, 12 months post-ACLR. Individuals with lower peak vGRF LSI 6 months post-ACLR demonstrated worse patient-reported outcomes (KOOS Pain, Activities of Daily life, Sport and Recreation, Quality of Life) at the 12-month exam. A peak vGRF LSI ≥0.99 6 months following ACLR associated with 13.33× higher odds of reporting acceptable patient-reported outcomes 12 months post-ACLR. Lesser peak vGRF LSI during walking at 6-months post-ACLR may be a critical indicator of worse future patient-reported outcomes. Clinical significance achieving early symmetrical lower extremity loading and minimizing under-loading of the ACLR limb during walking may be a potential therapeutic target for improving patient-reported outcomes post-ACLR. © 2018 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res.

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confidence: 80%

Walking gait asymmetries 6 months following anterior cruciate ligament reconstruction predict 12‐month patient‐reported outcomes

Pietrosimone

Blackburn

Padua

et al. 2018

Journal Orthopaedic Research

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“…Specifically, lower KOOS scores are associated with magnetic resonance imaging outcomes related to altered femoral cartilage composition 12 months after ACLR, (2) suggesting worse patient-reported outcomes may be related to the early development of posttraumatic osteoarthritis (PTOA). Furthermore, persistent knee symptoms are associated with chronic abnormal loading of the lower extremity, (3,4) potentially hastening deleterious changes in joint tissues. (5)(6)(7)(8) Unfortunately, the association between lower extremity loading and persistent clinically relevant knee symptoms is unclear.…”

Section: Introductionmentioning

confidence: 99%

Walking Ground Reaction Force Post-ACL Reconstruction: Analysis of Time and Symptoms

Pietrosimone

Seeley

Johnston

et al. 2019

Medicine &Amp; Science in Sports &Amp; Exercise

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Relative to asymptomatic individuals, symptomatic individuals are more likely to underload the ACLR limb early following ACLR (i.e., <12 months) during both vGRF peaks, but overload the ACLR limb, during both vGRF peaks, at later time points (i.e., >24 months). We propose these differences in lower extremity loading during walking might have implications for long-term knee health, and should be considered when designing therapeutic interventions for individuals with an ACLR.

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“…There were no significant differences in knee excursion during stance (24 weeks: −0.10±0.44, 0.29±0.64; 48 weeks: 0.34±0.49; Asaeda et al, 2017;Di Stasi et al, 2015;Roewer et al, 2011). Medium and large increases in peak knee flexion angle were observed during weight acceptance of stance (24 weeks: 0.15±0.54, 0.66±0.50; 48 weeks: 0.80±0.31; Roewer et al, 2011;Teng et al, 2017). Average knee angle data demonstrated mostly non-significant differences with a significantly more flexed position three weeks post-surgery being the exception (Devita et al, 1997;Ferber et al, 2004;Shabani et al, 2015).…”

Section: Gaitmentioning

confidence: 98%

“…Thirty-one articles assessed gait biomechanics however, eight articles were not included due to duplicate (DeVita et al, 1996;Ferber, 2001;Hartigan, 2009;Knoll et al, 2004a;Tagesson & Kvist, 2016;Tagesson et al, 2015) or unavailable data (Azus et al, 2017;Laforest et al, 2017), resulting in 23 articles undergoing analysis (Table 1). Kinematic outcome measures such as joint excursions and tibial translation were the most commonly reported data (Table 1).…”

Section: Gaitmentioning

confidence: 99%

Lower limb biomechanics before and after anterior cruciate ligament reconstruction: A systematic review

Moore

Cessford

Willmott

et al. 2020

Journal of Biomechanics

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This review aimed to synthesise the findings of literature that have assessed the changes in lower limb biomechanics following anterior cruciate ligament (ACL) reconstructive surgery. Systematic searches of CINHAL, MEDLINE, SCOPUS, and SPORTDiscus databases were run. All included studies had presented biomechanical variables pre-and post-surgery for the same participants. Articles were categorised by the analysed movement, and effect sizes were calculated.Fifty-four studies met the inclusion criteria, providing data on gait (n=31), balance (n=12), joint position sense (n=5), stair ambulation (n=4), pivoting (n=6), and landing (n=5). Measures of balance performance and joint position sense showed improvements from pre-to post-surgery. Changes in joint kinematics were inconsistent between studies, however increased knee flexion excursion, and reduced tibial anterior translation and internal rotation post reconstruction were identified. Joint kinetics reduced in magnitude in the early stages after surgery (≤5 weeks), then increased later in recovery (≥24 weeks). Risk of bias assessment identified most articles had a moderate or high risk (low=5; moderate=21; high=11) resulting from participant retention and surgical intervention differences. The results of the review identified that although lower limb biomechanics did alter following reconstruction, few variables provided consistent results across studies and tasks.The low methodological quality of some articles may have contributed to these inconsistent findings. Alternatively, differences across studies may have resulted from individual coping strategies of participants that have previously been suggested to be present before reconstructive surgery, and future research should look to explore individual coping strategies to ACL reconstruction.

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Biomechanical Factors Associated With Pain and Symptoms Following Anterior Cruciate Ligament Injury and Reconstruction

Abstract: IV.

Cited by 11 publications

References 37 publications

Walking gait asymmetries 6 months following anterior cruciate ligament reconstruction predict 12‐month patient‐reported outcomes

Walking gait asymmetries 6 months following anterior cruciate ligament reconstruction predict 12‐month patient‐reported outcomes

Walking Ground Reaction Force Post-ACL Reconstruction: Analysis of Time and Symptoms

Lower limb biomechanics before and after anterior cruciate ligament reconstruction: A systematic review

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