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Med Sci Sports Exerc. 2019 Nov 27. doi: 10.1249/MSS.0000000000002208. [Epub ahead of print]

Bilateral Gait Six and Twelve Months Post-ACL Reconstruction Compared to Controls.

Author information

1
MOTION Science Institute, Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC.
2
Human Movement Science Curriculum, University of North Carolina at Chapel Hill, Chapel Hill, NC.
3
Department of Exercise Sciences, Brigham Young University, Provo, UT.
4
Division of Rheumatology, Allergy and Immunology, Tufts Medical Center, Boston MA, and Department of Population and Quantitative Health Science, University of Massachusetts Medical School, Worcester, MA.
5
Department of Orthopaedics, School of Medicine, University of North Carolina at Chapel Hill, NC.

Abstract

PURPOSE:

To compare gait biomechanics throughout stance phase 6 and 12 months following unilateral anterior cruciate ligament reconstruction (ACLR) between ACLR and contralateral limbs and compared to controls.

METHODS:

Vertical ground reaction force (vGRF), knee flexion angle (KFA), and internal knee extension moment (KEM) were collected bilaterally 6 and 12 months post-ACLR in 30 individuals (50% female, 22±3 years, body mass index [BMI]=23.8±2.2kg/m) and at a single time point in 30 matched uninjured controls (50% female, 22±4 years, BMI=23.6±2.1kg/m). Functional analyses of variance were used to evaluate the effects of limb (ACLR, contralateral, and control) and time (6 and 12 months) on biomechanical outcomes throughout stance.

RESULTS:

Compared to the uninjured controls, the ACLR group demonstrated bilaterally lesser vGRF (ACLR=9%BW, contralateral=4%BW) during early stance and greater vGRF during mid-stance (ACLR=5%BW, contralateral=4%BW) 6 months post-ACLR. Compared to the uninjured controls, the ACLR group demonstrated bilaterally lesser vGRF (ACLR=10%BW, contralateral=8%BW) during early stance and greater vGRF during mid-stance (ACLR=5%BW, contralateral=5%BW) 12 months post-ACLR. Compared to controls, the ACLR limb demonstrated lesser KFA during early stance at 6 (2.3°) and 12 months post-ACLR (2.0°), and the contralateral limb demonstrated lesser KFA during early stance at 12 months post-ACLR (2.8°). Compared to controls, the ACLR limb demonstrated lesser KEM during early stance at both 6 (0.011BW*height) and 12 months (0.007BW*height) post-ACLR, and the contralateral limb demonstrated lesser KEM during early stance only at 12 months (0.006BW*height).

CONCLUSION:

Walking biomechanics are altered bilaterally following ACLR. During the first 12 months post-ACLR, both the ACLR and contralateral limbs demonstrate biomechanical differences compared to control limbs. Differences between the contralateral and control limbs increase from 6 to 12 months post-ACLR. Key Terms: Vertical ground reaction force, knee flexion angle, knee extension moment, walking biomechanics, anterior cruciate ligament.

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