Three-dimensional kinematic and kinetic gait deviations in individuals with chronic anterior cruciate ligament deficient knee: A systematic review and meta-analysis

Ismail, Shiek Abdullah; Button, Kate; Simić, Milena; Deursen, Robert William Martin Van; Pappas, Evangelos

doi:10.1016/j.clinbiomech.2016.04.002

Cited by 18 publications

(22 citation statements)

References 136 publications

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“…Two recent systematic reviews and meta‐analyses have investigated interlimb differences in long‐term walking patterns in patients after operative and nonoperative treatment of ACL injury 4,6 . The results of the present study are in accordance with these reviews that reported no interlimb differences in sagittal plane knee joint angles or moments during loading response of gait in both operative and nonoperative groups of patients at least 3 years after ACL reconstruction or ACL injury (if treated nonoperatively).…”

Section: Discussionsupporting

confidence: 90%

“…The progression of frontal plane joint moments after ACL injury is less clear that its sagittal plane counterparts. For example, no studies included in the systematic review by Ismail et al compared interlimb differences in the frontal plane in nonoperatively treated patients 6 . In the current study, patients completing nonoperative ACL management walked with a greater knee adduction moment than the contralateral limb and the injured limb of those completing operative management.…”

Section: Discussionmentioning

confidence: 63%

“…Secondary variables of interest included peak knee flexion angle, peak knee adduction angle (during first 50% of stance), peak knee flexion moment, peak knee adduction moment (during first 50% of stance), knee extensor muscle force, and knee flexor muscle force. These biomechanical variables were chosen because they are commonly altered after ACL injury 4‐6 and are associated with knee osteoarthritis development after ACL injury 8,36 . Knee extensor muscle force was defined as the sum of the rectus femoris, medial and lateral vasti, and vastus intermedius muscle forces at the time of peak medial compartment contact force.…”

Section: Methodsmentioning

confidence: 99%

“…While gait biomechanics have been extensively studied after operative treatment, fewer studies have investigated gait biomechanics following nonoperative ACL management. A systematic review and meta‐analysis by Ismail et al 6 reported no differences in sagittal plane knee angles and moments in patients treated nonoperatively 6 months of ACL injury compared with control cohorts. Ismail et al were unable to pool data regarding frontal plane angles and moments in nonoperative ACL cohorts secondary to limited quantitative reporting of these variables.…”

Section: Introductionmentioning

confidence: 99%

“…An estimated 120 000 ACL injuries occur each year in the United States, with the greatest incidence among high school and college‐aged individuals 1 . ACL injury results in a loss of knee joint stability and development of abnormal movement patterns 2‐6 . This has significant consequences as 50% of those with ACL injury develop knee osteoarthritis within 10 to 20 years of injury 7 .…”

Section: Introductionmentioning

confidence: 99%

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Operative and nonoperative management of anterior cruciate ligament injury: Differences in gait biomechanics at 5 years

Wellsandt

Khandha

Capin

et al. 2020

Journal Orthopaedic Research

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Gait biomechanics after anterior cruciate ligament (ACL) injury are associated with functional outcomes and the development of posttraumatic knee osteoarthritis. However, biomechanical outcomes between patients treated nonoperatively compared with operatively are not well understood. The primary purpose of this study was to compare knee joint contact forces, angles, and moments during loading response of gait between individuals treated with operative compared with nonoperative management at 5 years after ACL injury. Forty athletes treated operatively and 17 athletes treated nonoperatively completed gait analysis at 5 years after ACL reconstruction or completion of nonoperative rehabilitation. Medial compartment joint contact forces were estimated using a previously validated, patient‐specific electromyography‐driven musculoskeletal model. Knee joint contact forces, angles, and moments were compared between the operative and nonoperative group using mixed model 2 × 2 analyses of variance. Peak medial compartment contact forces were larger in the involved limb of the nonoperative group (Op: 2.37 ± 0.47 BW, Non‐Op: 3.03 ± 0.53 BW; effect size: 1.36). Peak external knee adduction moment was also larger in the involved limb of the nonoperative group (Op: 0.25 ± 0.08 Nm/kg·m, Non‐Op: 0.32 ± 0.09 Nm/kg·m; effect size: 0.89). No differences in radiographic tibiofemoral osteoarthritis were present between the operative and nonoperative groups. Overall, participants treated nonoperatively walked with greater measures of medial compartment joint loading than those treated operatively, while sagittal plane group differences were not present. Statement of clinical relevance: The differences in medial knee joint loading at 5 years after operative and nonoperative management of ACL injury may have implications on the development of posttraumatic knee osteoarthritis.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 63%