Gait changes of the ACL-deficient knee 3D kinematic assessment

Shabani, Bujar; Bytyqi, Dafina; Lustig, Sébastien; Chèze, Laurence; Bytyqi, Cen; Neyret, Philippe

doi:10.1007/s00167-014-3169-0

Cited by 52 publications

(35 citation statements)

References 50 publications

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“…For sagittal plane kinematics, the uninvolved limb of the ACLD group demonstrated pKFA during weight acceptance, compared to controls. A recent study that measured the knee flexion angle for an ACLD versus control group has reported greater knee flexion angle values for the involved limb, compared to controls, throughout the stance phase. In the present study, while the mean pKFA value for involved limb of the ACLD group was greater compared to controls, the difference was not significant.…”

Section: Discussionmentioning

confidence: 99%

High muscle co‐contraction does not result in high joint forces during gait in anterior cruciate ligament deficient knees

Khandha

Manal

Capin

et al. 2018

Journal Orthopaedic Research

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The mechanism of knee osteoarthritis development after anterior cruciate ligament injuries is poorly understood. The objective of this study was to evaluate knee gait variables, muscle co-contraction indices and knee joint loading in young subjects with anterior cruciate ligament deficiency (ACLD, n = 36), versus control subjects (n = 12). A validated, electromyography-informed model was used to estimate joint loading. For the involved limb of ACLD subjects versus control, muscle co-contraction indices were higher for the medial (p = 0.018, effect size = 0.93) and lateral (p = 0.028, effect size = 0.83) agonist-antagonist muscle pairs. Despite higher muscle co-contraction, medial compartment contact force was lower for the involved limb, compared to both the uninvolved limb (mean difference = 0.39 body weight, p = 0.009, effect size = 0.70) as well as the control limb (mean difference = 0.57 body weight, p = 0.007, effect size = 1.14). Similar observations were made for total contact force. For involved versus uninvolved limb, the ACLD group demonstrated lower vertical ground reaction force (mean difference = 0.08 body weight, p = 0.010, effect size = 0.70) and knee flexion moment (mean difference = 1.32% body weight * height, p = 0.003, effect size = 0.76), during weight acceptance. These results indicate that high muscle co-contraction does not always result in high knee joint loading, which is thought to be associated with knee osteoarthritis. Long-term follow-up is required to evaluate how gait alterations progress in non-osteoarthritic versus osteoarthritic subjects. © 2018 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res.

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Section: Discussionmentioning

confidence: 99%

High muscle co‐contraction does not result in high joint forces during gait in anterior cruciate ligament deficient knees

Khandha

Manal

Capin

et al. 2018

Journal Orthopaedic Research

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“…A recent study of in vivo 3-dimensional gait kinematics between anterior cruciate ligament (ACL)–deficient knees and ACL-intact knees reported a significant increase of 1.4° ± 0.2° in internal rotation in the ACL deficient group. 39 The ACL-deficient knee patients were noncopers and unable to return to their premorbid level of sports play or activity. An amplitude of greater than 2° was therefore believed to be a clinically relevant amount of rotational instability in this study.…”

Section: Discussionmentioning

confidence: 99%

The Role of the Peripheral Passive Rotation Stabilizers of the Knee With Intact Collateral and Cruciate Ligaments: A Biomechanical Study

Vap

Schon

Moatshe

et al. 2017

Orthopaedic Journal of Sports Medicine

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Background:A subset of patients have clinical internal and/or external knee rotational instability despite no apparent injury to the cruciate or collateral ligaments.Purpose/Hypothesis:The purpose of this study was to assess the effect of sequentially cutting the posterolateral, anterolateral, posteromedial, and anteromedial structures of the knee on rotational stability in the setting of intact cruciate and collateral ligaments. It was hypothesized that cutting of the iliotibial band (ITB), anterolateral ligament and lateral capsule (ALL/LC), posterior oblique ligament (POL), and posteromedial capsule (PMC) would significantly increase internal rotation, while sectioning of the anteromedial capsule (AMC) and the popliteus tendon and popliteofibular ligament (PLT/PFL) would lead to a significant increase in external knee rotation.Study Design:Controlled laboratory study.Methods:Ten pairs (N = 20) of cadaveric knees were assigned to 2 sequential cutting groups (group 1: posterolateral-to-posteromedial [PL → PM] and group 2: posteromedial-to-posterolateral [PM → PL]). Specimens were subjected to applied 5-N·m internal and external rotation torques at knee flexion angles of 0°, 30°, 60°, and 90° while intact and after each cut state. Rotational changes were measured and compared with the intact and previous cut states.Results:Sectioning of the ITB significantly increased internal rotation at 60° and 90° by 5.4° and 6.2° in group 1 (PL → PM) and 3.5° and 3.8° in group 2 (PM → PL). PLT/PFL complex sectioning significantly increased external rotation at 60° and 90° by 2.7° and 2.9° in group 1 (PL → PM). At 60° and 90° in group 2 (PM → PL), ALL/LC sectioning produced significant increases in internal rotation of 3.1° and 3.5°, respectively. In group 2 (PM → PL), POL sectioning produced a significant increase in internal rotation of 2.0° at 0°. AMC sectioning significantly increased external rotation at 30° to 90° of flexion with a magnitude of change of <1° in both groups 1 (PL → PM) and 2 (PM → PL).Conclusion:Collectively, the anterolateral corner structures provided primary internal rotation control of the knee from 60° to 90° of knee flexion in knees with intact cruciate and collateral ligaments. The ITB was the most significant primary stabilizer of internal rotation. The POL had a primary role for internal rotational stability at full extension. The PLT/PFL complex was a primary stabilizer for external rotation of the knee at 60° and 90°.Clinical Relevance:This study delineates the primary and secondary roles of the ITB, ALL/LC, POL, and PLT/PFL to rotatory stability of the knee and provides new information to understand knee rotational instabilities.

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“…However, it is possible that the pathway to osteoarthritis differs between patients who are treated conservatively and those who are treated surgically. Rupture of the ACL leads to altered knee kinematics during daily activities including translational and rotational laxity and/or offset . Andriacchi et al suggested that this kinematic change results in greater loads on previously unloaded regions of articular cartilage that will initiate biological changes leading to osteoarthritis.…”

Section: Discussionmentioning

confidence: 99%

Comparison of volumetric bone mineral density in the operated and contralateral knee after anterior cruciate ligament and reconstruction: A 1‐year follow‐up study using peripheral quantitative computed tomography

Mündermann

Payer

Felmet

et al. 2015

Journal Orthopaedic Research

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The purpose of this study was to quantify changes in volumetric bone mineral density (vBMD) in the tibial plateau of the operated and contralateral leg measured using peripheral quantitative computed tomography (pQCT) before and 3, 6, and 12 months after anterior cruciate ligament (ACL) reconstruction. The ACL was reconstructed with a hamstring tendon autograft using press-fit fixation. pQCT measurements of the proximal tibia were obtained in 61 patients after ACL reconstruction, and total, cortical, and trabecular vBMD were calculated. vBMD in the operated leg decreased from baseline to 3 months (À12% [total], À11% [cortical], and À12.6% [trabecular]; p < 0.001) and remained below baseline for 12 months after surgery (6 months: À9.5%, À9.4%, and À9.6%, p < 0.001; 12 months: À8%, À5%, and À11%, p < 0.001). vBMD in the contralateral leg was slightly reduced only 6 months after surgery. Including age and sex as covariates into the analysis did not affect the results. ACL reconstruction contributed to loss in bone mineral density within the first year after surgery. The role of factors such as time of weight-bearing, joint mechanics, post-traumatic inflammatory reactions, or genetic predisposition in modulating the development of posttraumatic knee osteoarthritis after ACL injury should be further elucidated. ß

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Gait changes of the ACL-deficient knee 3D kinematic assessment

Abstract: The findings in this study indicate that ACLD knee may adapt functionally to prevent excessive anterior-posterior translation but they fail to avoid rotational instability.

Cited by 52 publications

References 50 publications

High muscle co‐contraction does not result in high joint forces during gait in anterior cruciate ligament deficient knees

High muscle co‐contraction does not result in high joint forces during gait in anterior cruciate ligament deficient knees

The Role of the Peripheral Passive Rotation Stabilizers of the Knee With Intact Collateral and Cruciate Ligaments: A Biomechanical Study

Comparison of volumetric bone mineral density in the operated and contralateral knee after anterior cruciate ligament and reconstruction: A 1‐year follow‐up study using peripheral quantitative computed tomography

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