ACL reconstruction may alter gait biomechanics, increase patient risk for knee OA
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Key takeaways:
- ACL reconstruction may negatively alter gait mechanics and increase patient risk for postoperative knee osteoarthritis.
- ACL reconstruction was associated with less dynamic gait biomechanics vs. healthy controls.
Published results showed patients who underwent unilateral ACL reconstruction had less dynamic gait biomechanics waveforms bilaterally at 1 year postoperatively compared with healthy controls.
In addition, patients who undergo ACL reconstruction and develop abnormal gait biomechanics may be at increased risk for knee osteoarthritis vs. healthy controls.
Christin Büttner, MS, PhD, from the department of exercise and sport science at the University of North Carolina, and colleagues performed a prospective, longitudinal cohort study of 59 patients (mean age, 21.8 years) who underwent primary, unilateral ACL reconstruction and 58 patients (mean age, 21.6 years) who did not undergo ACL reconstruction.
According to the study, Büttner and colleagues assessed gait biomechanics at walking speed using a 3D motion capture system and force plates. They compared gait between the ACL reconstructed limb and unoperated limb, the ACL reconstructed limb and controls, and the unoperated limb and controls. Biomechanical outcomes included vertical ground reaction force, knee flexion angle, knee extension moment and knee adduction moment.
Patients in the ACL reconstruction cohort were assessed at 2 months, 4 months, 6 months and 1 year postoperatively, while patients in the control cohort were assessed during a single data collection session. Among the ACL reconstruction cohort, 54 patients were available at 2-month follow-up, 55 patients were available at 4-month follow-up, 53 patients were available at 6-month follow-up and 50 patients were available at 1-year follow-up.
Compared with the unoperated limb, the ACL reconstructed limb had decreased knee extension moment during early stance and decreased knee flexion moment and increased knee flexion angle during mid‐stance to late stance at all postoperative follow-up timepoints.
Büttner and colleagues found the ACL reconstructed limb had decreased vertical ground reaction force, knee extension moment and knee adduction moment during early stance, as well as increased vertical ground reaction force and knee flexion angle during mid‐stance to late stance at all postoperative follow-up timepoints compared with controls. They also found the unoperated limb had decreased knee flexion angle and knee extension moment during early to mid‐stance at all postoperative follow-up timepoints compared with controls.
“The results of this study are critical for the development of precision gait retraining interventions to normalize gait biomechanics and mitigate future knee OA development,” Büttner and colleagues wrote in the study.
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