Tibial Rotation Under Combined In Vivo Loading After Single- and Double-Bundle Anterior Cruciate Ligament Reconstruction

Tsarouhas, Alexander; Iosifidis, Michael; Spyropoulos, Giannis; Kotzamitelos, Dimitrios; Tsatalas, Themistoklis

doi:10.1016/j.arthro.2011.06.028

Cited by 18 publications

(30 citation statements)

References 35 publications

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“…The pivoting maneuver applied in the present study has previously been used to investigate tibial rotation in ACLD knees (Ristanis et al, 2006 , Tsarouhas et al, 2011 ). Similar to our study, these two studies compared ACLD knees to both the contralateral ACLI knee and a knee healthy control group.…”

Section: Discussionmentioning

confidence: 99%

Three-dimensional kinematic and kinetic analysis of knee rotational stability in ACL-deficient patients during walking, running and pivoting

et al. 2016

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BackgroundAnterior cruciate ligament (ACL) deficiency leads to altered stability of the knee. The purpose of this study was to compare the dynamic, rotational stability of the knee, expressed as rotational stiffness, between anterior cruciate ligament-deficient (ACLD) knees, their contralateral intact knees (ACLI) and a knee healthy control group during walking, running and 90° pivoting. We hypothesized a larger tibial internal rotation, a smaller knee joint external moment and a lower rotational stiffness in the ACLD group compared to the ACLI and the control group.MethodsKinematic and kinetic data were collected from both legs of 44 ACLD patients and 16 healthy controls during walking, running and a pivoting maneuver (descending a staircase and immediately pivoting 90° on the landing leg). Motion data were captured using 8 high-speed cameras and a force-plate. Reflective markers were attached to bony landmarks of the lower limb and rigid clusters on the shank and thigh (CASH model). Maximum internal tibial rotation and the corresponding rotational moment were identified for all tasks and groups and used to calculate rotational stiffness (= Δmoment /Δrotation) of the knee.ResultsThe tibial internal rotation of the ACLD knee was not significantly different from the ACLI knee during all three tasks. During walking and running, the tibial rotation of the control group was significantly different from both legs of the ACL-injured patient. For pivoting, no difference in tibial rotation between knees of the ACLD, ACLI and the control group was found. Knee joint external moments were not significantly different between the three groups during walking and pivoting. During running, the moments of the ACLI group were significantly higher than both the knees of the ACLD and the control group. Rotational stiffness did not differ significantly between groups in any of the three tasks.ConclusionA high-intensity activity combining stair descent and pivoting produces similar angular rotations, knee joint external moments and rotational stiffness in ACLD knees compared to ACLI knees and the control group. During running, the ACLI knee displayed a higher external moment than the ACLD and the healthy control group. This could indicate some type of protective strategy or muscular adaptation in the ACL-injured patients.

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Section: Discussionmentioning

confidence: 99%

Three-dimensional kinematic and kinetic analysis of knee rotational stability in ACL-deficient patients during walking, running and pivoting

et al. 2016

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“…However, they showed that compensation occurs at hip level. On the other hand, Tsarouhas et al (17) reported, using a step-cut manoeuvre task, lower values of internal rotation moment in ACLd knees compared to the contralateral knee and the control group.…”

Section: Discussionmentioning

confidence: 97%

“…The pivot-shift test has the highest specificity, but only moderate sensitivity and reliability, and is highly examiner dependent (14). The pivot shift test involves motion in more than one plane, but evaluations of rotational stability should be performed under weight bearing conditions, thus reflecting real life instability (15)(16)(17). Previous biomechanical studies focused on the kinematics and kinetics in the sagittal and coronal planes, but less on transverse plane kinetics (12).…”

Section: Abstract Anterior Cruciate Ligament Injury; Kinematics; Kinmentioning

confidence: 99%

Anterior cruciate ligament deficiency: rotational instability in the transverse plane. A preliminary laboratory in vivo study

Ferrer

Twycross-Lewis

Maffulli

2019

Muscle Ligaments and Tendons J

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Background. Rotational instability is a major feature of anterior cruciate ligament (ACL) deficiency. Few biomechanical studies have focused on the transverse plane when assessing the function of the ACL. Objective. To analyse the biomechanics of ACL deficient knees in the transverse plane under torsional conditions to detect rotational instability. Methods. Seven subjects (eight ACL deficiency) (ACLd group) and nine recreational athletes (controls) were recruited. Each performed two tasks: crossover and pivoting-jump. Biomechanical data were collected in a movement analysis laboratory. Comparisons were made for torque, rotation and torque curves in transverse plane between ACLd, contralateral knees and controls. Results. Torque curves showed and initial avoidance pattern followed by increased values in crossover task, and lesser values for ACLd group compared to controls in pivoting-jump task. Internal rotation in crossover was 19.8°, 13.7° and 19.1° for ACLd, contralateral and controls respectively (p = 0. 176). In pivoting-jump these values were 18.6°, 13.8° and 18.1° (p = 0.297). Crossover peak torque were 257, 178.4 and 184.8 Nmm for ACLd, contralateral and controls (p = 0.5), while pivoting-jump values were 238.4, 152.2 and 218 Nmm for ACLd, contralateral and controls (p = 0.288). Conclusion. Torque curve analysis identified a distinctive pattern differentiating ACLd and control group. However, no statistically significant differences were found in peak transverse plane parameters between groups.

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“…Tsarouhas et al (2011) noted that high-intensity activities combining stair ascending or descending with pivoting produce similar tibial rotation in SB and DB ACL-reconstructed patients. During such manoeuvres, the reconstructed knee may be subjected to significantly lower rotational loads compared with the intact knee [ 8 ]. Scanlan et al (2010) found abnormal rotation of the tibia in the stance phase of gait in the involved legs 2 years after ACLR [ 9 ].…”

Section: Discussionmentioning

confidence: 99%

“…Although Claes et al reported recovery of correct kinematics of tibial rotation six months after SB ACLR and DB ACLR, they did not show the DB ACLR approach to be any better than SB ACLR regarding effects on gait kinematics and other dynamic physical activities [ 7 ]. Tsarouhas et al did not report any differences in tibial rotation and peak torque between SB ACLR and DB ACLR groups during gait or while walking up and down stairs; however, peak torque values obtained from the involved legs were lower in both groups compared with the values obtained from the uninvolved side [ 8 ]. Scanlan et al found higher values reflecting tibial rotation in the stance phase of gait in the involved legs in comparison with those obtained from the uninvolved legs 2 years after ACLR [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

Kinematics of Rotation in Joints of the Lower Limbs and Pelvis during Gait: Early Results—SB ACLR Approach versus DB ACLR Approach

Czamara¹,

Markowska²,

Królikowska³

et al. 2015

BioMed Research International

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It is difficult to find publications comparing rotation kinematics in large joints of the lower limbs and pelvis during gait in patients after single-bundle (SB) reconstruction of the anterior cruciate ligament (ACLR) with double-bundle (DB) ACLR of the knee. The aim of this study was to compare rotation kinematics in ankle, knee, and hip joints and the pelvis during gait in the 14th week after SB and DB ACLR. The subjects were males after SB (n = 10) and DB (n = 13) ACLR and a control group (n = 15). The values of kinematic parameters were recorded during internal (IR) and external (ER) rotation in the joints during gait using the BTS SMART. The SB ACLR group obtained significantly higher values of ER in the involved knee comparing to DB ACLR and controls and excessive IR in the hip comparing to controls. In the DB ACLR group, excessive ER was noted in the involved leg's foot. Comparing with the DB ACLR and control groups, SB ACLR subjects had more substantial disorders of rotation kinematics in the lower limb joints. However, in both ACLR groups, 14 weeks of postoperative physiotherapy were not enough to fully restore rotation kinematics in joints of the lower limbs during gait.

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Tibial Rotation Under Combined In Vivo Loading After Single- and Double-Bundle Anterior Cruciate Ligament Reconstruction

Cited by 18 publications

References 35 publications

Three-dimensional kinematic and kinetic analysis of knee rotational stability in ACL-deficient patients during walking, running and pivoting

Three-dimensional kinematic and kinetic analysis of knee rotational stability in ACL-deficient patients during walking, running and pivoting

Anterior cruciate ligament deficiency: rotational instability in the transverse plane. A preliminary laboratory in vivo study

Kinematics of Rotation in Joints of the Lower Limbs and Pelvis during Gait: Early Results—SB ACLR Approach versus DB ACLR Approach

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