Patellofemoral Joint Loads During Running at the Time of Return to Sport in Elite Athletes With ACL Reconstruction

Herrington, Lee; Alarifi, Saud; Jones, Richard

doi:10.1177/0363546517716632

Cited by 25 publications

(28 citation statements)

References 31 publications

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“…In addition, our PFJ contact force estimates for both limbs were within the range of published results (4.5-11.1 BW) for running studies in which joint moments, instead of explicitly calculated muscle forces, were input into the PFJ model. 6,18,26,39,40…”

Section: Discussionmentioning

confidence: 99%

“…36 However, limited research has been performed to assess the effect of ACLR on lower limb biomechanics during running. Available studies have reported lower knee flexion angles, knee range of motion, and knee extension moments, 26,34,43 together with increased knee external rotation 45,46 and anterior tibial translation 46 up to 12 months postoperatively. Only 2 studies to date have investigated PFJ loads during running after ACLR surgery.…”

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confidence: 99%

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Between-Limb Differences in Patellofemoral Joint Forces During Running at 12 to 24 Months After Unilateral Anterior Cruciate Ligament Reconstruction

et al. 2020

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Background: Patellofemoral joint (PFJ) osteoarthritis may occur after anterior cruciate ligament reconstruction (ACLR). The mechanisms underpinning the development of PFJ osteoarthritis are not known but may relate to altered PFJ loading. Few studies have assessed PFJ loads during high-impact tasks, such as running, beyond the acute rehabilitation phase (ie, >12 months) after ACLR. Purpose/Hypothesis: The purpose was to compare between-limb joint angles, joint moments, and PFJ contact force during running in individuals at 12 to 24 months after unilateral ACLR. We hypothesized that peak knee flexion angle, knee extension moment, and PFJ contact force during stance would be lower in the ACLR limb compared with the uninjured limb. Study Design: Controlled laboratory study. Methods: A total of 55 participants (mean ± SD age, 28 ± 7 years), 12 to 24 months after ACLR, ran at a self-selected speed (2.9 ± 0.3 m/s). Measured kinematics and ground-reaction forces were input into musculoskeletal models to calculate joint moments and muscle forces. These values were subsequently input into a PFJ model to calculate contact force peak and impulse. Outcome measures were compared between the ACLR and uninjured limbs. Results: In the ACLR limb, compared with the uninjured limb, the PFJ contact force displayed a lower peak (ACLR, 6.1 ± 1.3 body weight [BW]; uninjured, 6.7 ± 1.4 BW; P < .001) and impulse (ACLR, 0.72 ± 0.17 BW*seconds [BWs]; uninjured, 0.81 ± 0.17 BWs; P < .001). At the time of the peak PFJ contact force, the knee extension moment was lower in the ACLR limb (ACLR, 14.0 ± 2.4 %BW*height [%BW*HT]; uninjured, 15.5 ± 2.5 %BW*HT; P < .001). The opposite was true for the ankle plantarflexion moment (ACLR, 12.1 ± 2.6 %BW*HT; uninjured, 11.5 ± 2.7 %BW*HT; P = .019) and the hip extension moment (ACLR, 2.3 ± 2.5 %BW*HT; uninjured, 1.6 ± 2.3 %BW*HT; P = .013). The foot-ground center of pressure was located more anteriorly with respect to the ankle joint center (ACLR, 5.8 ± 0.9 %height [%HT]; uninjured, 5.4 ± 1.0 %HT; P = .001). No differences were found for the sagittal plane hip, knee, and ankle angles. Conclusion: The ACLR limb experienced lower peak PFJ loads during running, explained by a small anterior shift in the foot-ground center of pressure during stance that offloaded the torque demand away from the ACLR knee. Clinical Relevance: Lower net PFJ loading during running in the ACLR limb more than 12 months after ACLR suggests that underloading might play a role in the onset of PFJ osteoarthritis after ACLR.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

Between-Limb Differences in Patellofemoral Joint Forces During Running at 12 to 24 Months After Unilateral Anterior Cruciate Ligament Reconstruction

et al. 2020

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“…[5][6][7][8] Biomechanical differences between limbs after ACLR have been found in variables relating to the knee during gait, running and jumping tasks principally relating to knee extension moments and vertical ground reaction forces. [9][10][11][12] Previous research has suggested that biomechanical variables captured during double-leg drop jumps (DLDJ) may predict primary anterior cruciate ligament (ACL) injury as well as secondary injury, 13,14 however the primary injury analysis was in female athletes only. Biomechanical variables both proximal and distal to the knee (i.e.…”

Section: Introductionmentioning

confidence: 99%

Whole‐body biomechanical differences between limbs exist 9 months after ACL reconstruction across jump/landing tasks

King

Richter

Franklyn-Miller

et al. 2018

Scandinavian Med Sci Sports

118

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“…Even in the absence of anterior interval scar, load in the patellofemoral joint is increased after ACL reconstruction. 7 However, scarring of the anterior interval can cause patella baja and may lead to patellofemoral arthritis. 5 The rate of patella baja after autogenous patellar tendon ACL reconstruction has been reported to be as high as 76% in 1 case series.…”

Section: Discussionmentioning

confidence: 99%

Surgical Technique for Release of Anterior Interval Scarring of the Knee After Anterior Cruciate Ligament Reconstruction

Rose

McNeilan

Genuario

et al. 2018

Arthroscopy Techniques

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Postoperative scarring is a known complication after arthroscopic anterior ligament reconstruction of the knee. The anterior interval of the knee has been previously identified as a common location for anterior scar formation. The anterior interval is defined as the space between the infrapatellar fat pad and the anterior border of the tibia. Patients with anterior interval scarring often present with lack of terminal knee extension, anterior knee pain, decreased patellar mobility, and quadriceps atrophy. The goal of this paper is to describe the technique for anterior interval release of the knee.

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Patellofemoral Joint Loads During Running at the Time of Return to Sport in Elite Athletes With ACL Reconstruction

Abstract: Altered levels of patellofemoral stress in the ACLR knee during running may predispose individuals to patellofemoral joint pain.

Cited by 25 publications

References 31 publications

Between-Limb Differences in Patellofemoral Joint Forces During Running at 12 to 24 Months After Unilateral Anterior Cruciate Ligament Reconstruction

Between-Limb Differences in Patellofemoral Joint Forces During Running at 12 to 24 Months After Unilateral Anterior Cruciate Ligament Reconstruction

Whole‐body biomechanical differences between limbs exist 9 months after ACL reconstruction across jump/landing tasks

Surgical Technique for Release of Anterior Interval Scarring of the Knee After Anterior Cruciate Ligament Reconstruction

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