Gait mechanics after ACL reconstruction: implications for the early onset of knee osteoarthritis

Butler, Robert J.; Minick, Kate I.; Ferber, Reed; Underwood, Frank B.

doi:10.1136/bjsm.2008.052522

Cited by 163 publications

(154 citation statements)

References 33 publications

Supporting

Mentioning

139

Contrasting

Unclassified

Order By: Relevance

“…Previously, ACLinjured individuals were known to be at high risk for ACL injury [19][20][21] and to have faulty movement patterns. [22][23][24] Removing these athletes may have further limited the predictive ability of the LESS in this population because many individuals who could have been detected by the LESS might have been filtered from the source population. Another factor to consider when comparing our observations and those of Smith et al 15 is differences in sport or athlete type between studies.…”

Section: Discussionmentioning

confidence: 99%

The Landing Error Scoring System as a Screening Tool for an Anterior Cruciate Ligament Injury–Prevention Program in Elite-Youth Soccer Athletes

Padua

DiStefano

Beutler

et al. 2015

Journal of Athletic Training

320

294

View full text Add to dashboard Cite

Context: Identifying neuromuscular screening factors for anterior cruciate ligament (ACL) injury is a critical step toward large-scale deployment of effective ACL injury-prevention programs. The Landing Error Scoring System (LESS) is a valid and reliable clinical assessment of jump-landing biomechanics.Objective: To investigate the ability of the LESS to identify individuals at risk for ACL injury in an elite-youth soccer population.Design: Cohort study. Setting: Field-based functional movement screening performed at soccer practice facilities.Patients or Other Participants: A total of 829 elite-youth soccer athletes (348 boys, 481 girls; age ¼ 13.9 6 1.8 years, age range ¼ 11 to 18 years), of whom 25% (n ¼ 207) were less than 13 years of age.Intervention(s): Baseline preseason testing for all participants consisted of a jump-landing task (3 trials). Participants were followed prospectively throughout their soccer seasons for diagnosis of ACL injuries (1217 athlete-seasons of follow-up).Main Outcome Measure(s): Landings were scored for ''errors'' in technique using the LESS. We used receiver operator characteristic curves to determine a cutpoint on the LESS. Sensitivity and specificity of the LESS in predicting ACL injury were assessed.Results: Seven participants sustained ACL injuries during the follow-up period; the mechanism of injury was noncontact or indirect contact for all injuries. Uninjured participants had lower LESS scores (4.43 6 1.71) than injured participants (6.24 6 1.75; t 1215 ¼ À2.784, P ¼ .005). The receiver operator characteristic curve analyses suggested that 5 was the optimal cutpoint for the LESS, generating a sensitivity of 86% and a specificity of 64%.Conclusions: Despite sample-size limitations, the LESS showed potential as a screening tool to determine ACL injury risk in elite-youth soccer athletes.Key Words: children, knee, biomechanics, movement patterns Key PointsThe Landing Error Scoring System (LESS) score may effectively identify elite-youth soccer athletes at higher risk of sustaining anterior cruciate ligament (ACL) injuries. Elite-youth soccer athletes with LESS scores of 5 or more were at higher risk of sustaining ACL injuries than athletes with LESS scores less than 5. Individuals with LESS scores of 5 or more may be targeted for ACL injury-prevention exercise programs.

show abstract

Section: Discussionmentioning

confidence: 99%

The Landing Error Scoring System as a Screening Tool for an Anterior Cruciate Ligament Injury–Prevention Program in Elite-Youth Soccer Athletes

Padua

DiStefano

Beutler

et al. 2015

Journal of Athletic Training

320

294

View full text Add to dashboard Cite

show abstract

“…The lasting effects of ACLR on an individual's knee biomechanics, as well as their muscle activation patterns, morphologies and strengths, may influence subsequent knee OA risk. During walking, ACLR individuals have a smaller knee flexion angle and moment (39), an increased knee adduction moment (9), and reduced vasti activation (6). Moreover, the donor muscles from which the ACL autograft is harvested subsequently experience fatty infiltration (40), atrophy (8,40) and muscle-belly retraction (50).…”

Section: Introductionmentioning

confidence: 99%

Tibiofemoral Contact Forces in the Anterior Cruciate Ligament–Reconstructed Knee

Saxby

Bryant

Modenese

et al. 2016

Medicine &Amp; Science in Sports &Amp; Exercise

View full text Add to dashboard Cite

show abstract

“…Although researchers 12,13 have demonstrated that greater medial compartment loading occurs during walking after ACL reconstruction, on the basis of our results, it does not appear that lateral BBs sustained concurrently with ACL injury contribute to these altered frontal-plane biomechanics. However, in these previous studies, the KAMs were substantially larger than those we reported, and the participants were tested postoperatively.…”

Section: Discussionmentioning

confidence: 75%

“…However, in these previous studies, the KAMs were substantially larger than those we reported, and the participants were tested postoperatively. In fact, Butler et al 12 tested participants an average of 5 years postoperatively, a time when radiographic osteoarthritis may be influencing lower extremity biomechanics. [24][25][26] When comparing KAM in the ACL þ BB and control groups with the ACL-injury group, we observed strong effect sizes with CIs that did not cross zero.…”

Section: Discussionmentioning

confidence: 99%

“…Altered frontal-plane knee-joint biomechanics have been demonstrated after ACL reconstruction, leading to increased KAM. 12,13 With PTOA commonly developing in the medial tibiofemoral compartment, 14 this adaptation is potentially hazardous. However, to date, no in vivo biomechanical studies have been conducted to confirm that altered frontal-plane biomechanics after ACL injury are related to lateral tibiofemoral BBs.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Knee Frontal-Plane Biomechanics in Adults With or Without Bone Marrow Edema-Like Lesions After Anterior Cruciate Ligament Injury

Thomas

Palmieri-Smith

2017

Journal of Athletic Training

View full text Add to dashboard Cite

Context: Lateral subchondral bone bruises (BBs) occur frequently with anterior cruciate ligament (ACL) injuries. These BBs are associated with pain during weight bearing, leading individuals to increase medial tibiofemoral loading to alleviate pain laterally. Increased medial tibiofemoral loading may precipitate the development or progression of posttraumatic osteoarthritis; however, no in vivo biomechanical data exist to confirm that lateral BBs increase medial tibiofemoral loading as measured by the external knee-adduction moment (KAM).Objective: To determine whether lateral BBs after ACL injury increase the external KAM during walking.Design: Descriptive laboratory study. Intervention(s): We recorded peak KAM during 3 walking trials (1.1 6 0.6 m/s) in which participants walked over a force platform located in the field of view of a motion-capture system.Main Outcome Measure(s): Peak KAM was calculated during the first half of stance using standard inverse-dynamics analysis, averaged across trials, and examined via 1-way analysis of variance. Knee pain and function were determined from the International Knee Documentation Committee Subjective Knee Evaluation Form and compared among groups via the Kruskal-Wallis test.Results: Peak KAM did not differ among groups (ACL injury ¼ 0.14 6 0.07 NmÁkg À1 Ám À1 , ACL þ BB ¼ 0.21 6 0.08 NmÁkg À1 Ám À1 , control ¼ 0.20 6 0.08 NmÁkg À1 Ám À1 ; F 2,35 ¼ 3.243, P ¼ .052). Knee-pain frequency and severity were greater in the ACL-injury (frequency ¼ 2.55 6 1.81, severity ¼ 3.36 6 1.75; both P , .001) and ACL þ BB (frequency ¼ 3.58 6 2.81, severity ¼ 4.08 6 3.20; both P , .001) groups than in the control group (frequency ¼ 0.00 6 0.00, severity ¼ 0.00 6 0.00). Knee function was greater in the control group (100.00 6 0.00) than in the ACL-injury (59.35 6 17.31; P , .001) and ACL þ BB (46.46 6 25.85; P , .001) groups.Conclusions: The ACL þ BB groups did not walk with a greater external KAM than the ACL-injury or control groups. Thus, lateral tibiofemoral BB did not influence knee frontal-plane loading after ACL injury.

show abstract

Gait mechanics after ACL reconstruction: implications for the early onset of knee osteoarthritis

Abstract: It seems that individuals who have undergone ACL reconstruction exhibit an increased peak knee-abduction moment that may establish a potential mechanism of the earlier onset of knee OA in this population.

Cited by 163 publications

References 33 publications

The Landing Error Scoring System as a Screening Tool for an Anterior Cruciate Ligament Injury–Prevention Program in Elite-Youth Soccer Athletes

The Landing Error Scoring System as a Screening Tool for an Anterior Cruciate Ligament Injury–Prevention Program in Elite-Youth Soccer Athletes

Tibiofemoral Contact Forces in the Anterior Cruciate Ligament–Reconstructed Knee

Knee Frontal-Plane Biomechanics in Adults With or Without Bone Marrow Edema-Like Lesions After Anterior Cruciate Ligament Injury

Contact Info

Product

Resources

About