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Am J Sports Med. 2005 Jul;33(7):982-9. Epub 2005 May 11.

Neuromuscular and biomechanical adaptations of patients with isolated deficiency of the posterior cruciate ligament.

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  • 1Neuromuscular Research Laboratory, UPMC Center for Sports Medicine, 3200 South Water Street, Pittsburgh, PA 15203, USA. tcs15@pitt.edu

Abstract

BACKGROUND:

Functional adaptations of patients with posterior cruciate ligament deficiency (grade II) are largely unknown despite increased recognition of this injury.

HYPOTHESIS:

Posterior cruciate ligament-deficient subjects (grade II, 6- to 10-mm bilateral difference in posterior translation) will present with neuromuscular and biomechanical adaptations to overcome significant mechanical instability during gait and drop-landing tasks.

STUDY DESIGN:

Controlled laboratory study.

METHODS:

Bilateral comparisons were made among 10 posterior cruciate ligament-deficient subjects using radiographic, instrumented laxity, and range of motion examinations. Biomechanical and neuromuscular characteristics of the involved limb of the posterior cruciate ligament-deficient subjects were compared to their uninvolved limb and to 10 matched control subjects performing gait and drop-landing tasks.

RESULTS:

Radiographic (15.3 +/- 2.9 to 5.6 +/- 3.7 mm; P = .008) and instrumented laxity (6.3 +/- 2.0 to 1.4 +/- 0.5 mm; P < .001) examinations demonstrated significantly greater posterior displacement of the involved knee within the posterior cruciate ligament-deficient group. The posterior cruciate ligament-deficient group had a significantly decreased maximum knee valgus moment and greater vertical ground reaction force at midstance during gait compared to the control group. During vertical landings, the posterior cruciate ligament-deficient group demonstrated a significantly decreased vertical ground reaction force loading rate. All other analyses reported no significant differences within or between groups.

CONCLUSION:

Posterior cruciate ligament-deficient subjects demonstrate minimal biomechanical and neuromuscular differences despite significant clinical laxity.

CLINICAL RELEVANCE:

The findings of this study indicate that individuals with grade II posterior cruciate ligament injuries are able to perform gait and drop-landing activities similar to a control group without surgical intervention.

PMID:
15888720
[PubMed - indexed for MEDLINE]
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