Factors affecting knee abduction during weight-bearing activities in individuals with anterior cruciate ligament reconstruction

Cronström, Anna; Ageberg, Eva; Smith, Melinda M. Franettovich; Blackmore, Tim; Nae, Jenny Älmqvist; Creaby, Mark W.

doi:10.1016/j.ptsp.2019.04.006

Cited by 9 publications

(13 citation statements)

References 51 publications

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“…6,14,69 However, based on our findings, no significant varus rotation was detected in either operative group during the lunge motion because the strength of the knee and trunk muscles could be restored better 1 year after surgery with appropriate rehabilitation, which contributed to knee varus-valgus rotation changes to a nearly normal status. 12 The potential onset of osteoarthritis via an altered knee varus-valgus profile might be correspondingly reduced over time.…”

Section: Discussionmentioning

confidence: 99%

Effects of Anterolateral Structure Augmentation on the In Vivo Kinematics of Anterior Cruciate Ligament–Reconstructed Knees

Chen

Wang

et al. 2021

Am J Sports Med

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Background: Double-bundle anterior cruciate ligament (ACL) reconstruction (ACLR) is a well-known treatment that restores the stability of ACL-deficient knees. However, some isolated ACL-reconstructed knees ultimately show rotatory laxity and develop osteoarthritis. Whether combined ACLR with anterolateral structure (ALS) augmentation (ALSA) can provide better improvement in the in vivo knee rotational kinematics remains unknown. Hypothesis: When compared with isolated double-bundle ACLR, combined double-bundle ACLR with ALSA can improve knee in vivo rotational kinematics and provide better restoration of knee kinematics. Study Design: Controlled laboratory study. Methods: Sixteen patients with unilateral ACL injury were randomly divided into 2 groups to receive either combined double-bundle ACLR and ALSA (ALSA group) or isolated double-bundle ACLR (ACLR group). All patients performed a single-leg lunge using the operative and nonoperative/contralateral legs under dual-fluoroscopic imaging system surveillance during a hospital visit at a minimum 1 year (12-13 months) of follow-up to assess the 6 degrees of freedom knee kinematics. Functional evaluation using the Lysholm and Marx rating scales and clinical examinations were also performed. Results: From full extension to approximately 90° of knee flexion at 5° intervals, the mean ± SD internal rotation of the reconstructed knees in the ALSA group (1.5°± 0.9°) was significantly smaller than that of the contralateral knees (8.2°± 1.9°; P = .008). The ALSA group knees also showed significantly ( P = .045) more medial translation than the contralateral knees. In the ACLR group, the mean internal rotation of the reconstructed knee (6.0°± 2.1°) was significantly smaller than that of the contralateral knees (8.9°± 0.6°; P < .001). At full extension, the tibia was significantly more externally rotated than that of the contralateral legs (0.5°± 7.4° vs 7.6°± 3.4°, P = .049). Conclusion: When compared with isolated double-bundle ACLR, double-bundle ACLR augmented with ALS reconstruction resulted in anterolateral rotatory overconstraint during the lunge motion. Clinical Relevance: Additional ALSA of double-bundle ACL-reconstructed knees overconstrained rotatory stability. Therefore, the use of ALSA for ACL-reconstructed knees should be considered with caution for patients with ACL deficiency and anterolateral rotatory instability. Longer-term follow-up to evaluate long-term outcomes and altered kinematics over time is recommended.

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Section: Discussionmentioning

confidence: 99%

Effects of Anterolateral Structure Augmentation on the In Vivo Kinematics of Anterior Cruciate Ligament–Reconstructed Knees

Chen

Wang

et al. 2021

Am J Sports Med

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“…Slater et al [91] pointed out that the peak knee flexion angle was smaller and the peak knee adduction angle was greater for the ACL injury patients in walking. Cronstrom et al [92] represented that the knee adduction degree during weight-bearing activities for ACLinjured patients was greater in walking. Gao and Zheng [93] indicated that the ACL-injured patients had slower speed and smaller stride length during walking.…”

Section: Knee Musculoskeletal Disorders and Its Biomechanicalmentioning

confidence: 99%

Knee Joint Biomechanics in Physiological Conditions and How Pathologies Can Affect It: A Systematic Review

Zhang

Liu

Han

et al. 2020

Applied Bionics and Biomechanics

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The knee joint, as the main lower limb motor joint, is the most vulnerable and susceptible joint. The knee injuries considerably impact the normal living ability and mental health of patients. Understanding the biomechanics of a normal and diseased knee joint is in urgent need for designing knee assistive devices and optimizing a rehabilitation exercise program. In this paper, we systematically searched electronic databases (from 2000 to November 2019) including ScienceDirect, Web of Science, PubMed, Google Scholar, and IEEE/IET Electronic Library for potentially relevant articles. After duplicates were removed and inclusion criteria applied to the titles, abstracts, and full text, 138 articles remained for review. The selected articles were divided into two groups to be analyzed. Firstly, the real movement of a normal knee joint and the normal knee biomechanics of four kinds of daily motions in the sagittal and coronal planes, which include normal walking, running, stair climbing, and sit-to-stand, were discussed and analyzed. Secondly, an overview of the current knowledge on the movement biomechanical effects of common knee musculoskeletal disorders and knee neurological disorders were provided. Finally, a discussion of the existing problems in the current studies and some recommendation for future research were presented. In general, this review reveals that there is no clear assessment about the biomechanics of normal and diseased knee joints at the current state of the art. The biomechanics properties could be significantly affected by knee musculoskeletal or neurological disorders. Deeper understanding of the biomechanics of the normal and diseased knee joint will still be an urgent need in the future.

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“…Cronström et al reported that lower knee muscle strength and lower muscle activation of the trunk was associated with increased 3D knee abduction in women, but not in men. 10 While there is some understanding of the sex differences and modifiable factors associated with knee abduction (one aspect of postural orientation), 9 36 further studies are needed to investigate underlying modifiable factors for other POEs, for example, muscle strength and muscle activation patterns, in men and women. Such information may help design rehabilitation programmes aimed at improving postural orientation in men and women after an ACL injury.…”

Section: Discussionmentioning

confidence: 99%

“…8 Thus, it is of importance to investigate sex differences in various measures of postural orientation, to guide rehabilitation progression for men and women, respectively. A systematic review 9 and recent crosssectional study 10 observed worse postural orientation, that is, greater 3D knee abduction angle, in both women with an ACL injury and healthy women, compared with men. In contrast, no sex differences were observed for visual assessment of Knee Medial-to-Foot Position (KMFP).…”

Section: Open Accessmentioning

confidence: 98%

“… 15 16 Poorer movement quality (referred to as ‘substitution patterns’) was associated with worse patient-reported knee function and lower knee-specific activity, and worse hop performance. 15 16 Although several studies have observed sex differences in various measures of physical function, for example, hop performance, 10 PROMs 17 18 and postural orientation (3D knee kinematics), 7 9 10 there is limited research on whether associations between physical functions differ between men and women.…”

Section: Introductionmentioning

confidence: 99%

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Sex differences in postural orientation errors and association with objective and patient-reported function in patients with ACL injury: an exploratory cross-sectional study

Nae

Creaby

Cronström

et al. 2021

BMJ Open Sport Exerc Med

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ObjectivesThere is limited research on sex differences in postural orientation (ie, alignment between body segments) in people with knee injury measured with a clinically applicable method. An understanding of the relationship between postural orientation and physical function may help guide decision making in rehabilitation. The aims were to evaluate (1) sex differences in visual assessment of Postural Orientation Errors (POEs) and (2) the association between POEs and objective and patient-reported physical function, in men and women with anterior cruciate ligament reconstruction (ACLR).MethodsTwenty-four women and 29 men (mean 26.7 (SD 6.5) years) with ACLR were included. Six POEs (lower extremity and trunk) were scored from a video of five tasks with varying difficulty to compute POE scores (total and subscores). Objective physical function was evaluated with the single-leg hop for distance and side hop. Patient-reported physical function was evaluated using patient-reported outcome measures (PROMs).ResultsWomen had significantly more POEs than men (median difference 5.5–25, p≤0.028). More POEs were associated with shorter hop distance and fewer side hops in women (rs= −0.425 to −0.518, p<0.038), but not in men (rs<0.301, p>0.05). No associations were found between POE scores and PROMs, in either sex (rs< –0.246, p>0.05).ConclusionsWomen with ACLR seem to have more POEs compared with men, indicating worse postural orientation. More POEs were associated with worse hop performance, suggesting that POE scores may be used as criteria for rehabilitation progression. The lack of associations between POE scores and PROMs indicate that these measures complement each other.

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Factors affecting knee abduction during weight-bearing activities in individuals with anterior cruciate ligament reconstruction

Cited by 9 publications

References 51 publications

Effects of Anterolateral Structure Augmentation on the In Vivo Kinematics of Anterior Cruciate Ligament–Reconstructed Knees

Effects of Anterolateral Structure Augmentation on the In Vivo Kinematics of Anterior Cruciate Ligament–Reconstructed Knees

Knee Joint Biomechanics in Physiological Conditions and How Pathologies Can Affect It: A Systematic Review

Sex differences in postural orientation errors and association with objective and patient-reported function in patients with ACL injury: an exploratory cross-sectional study

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