Contributors to knee loading deficits during gait in individuals following anterior cruciate ligament reconstruction.
Paige E Lin, Susan M Sigward
PMID 30170138WHAT IT FOUND
After ACL reconstruction, the surgical knee showed smaller knee extensor moments during walking.
Smaller braking forces and less knee flexion were related to the asymmetry. No gait intervention was tested.
Key findings
01Thirty people enrolled 108 ± 17 days after ACL reconstruction had reduced knee extensor moment, knee flexion range, posterior ground reaction force, and shank angular velocity in the surgical limb.
02Between limb knee extensor moment ratios averaged 0.86 ± 0.37, and posterior ground reaction force ratio and knee flexion range differences entered the prediction equation.
03Vertical ground reaction force did not differ between limbs.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The study included a small sample of people already in physical therapy and already walking at a comfortable speed, so it may not apply to earlier or more impaired stages of recovery. The study used the non-surgical limb as the normal reference, but that limb may not have normal mechanics. It measured associations at one time point, so it cannot show whether the knee loading deficits resolve, persist, or cause problems later. It did not test whether changing posterior ground reaction force or knee flexion range improves knee loading or patient outcomes. Other factors, such as muscle timing and whole body mechanics, were not measured and may explain part of the deficit.
Declared interests
No conflicts of interest were declared. The article metadata lists NIH extramural research support.
The easy way to misread this
Do not conclude that training posterior braking forces or knee flexion range will improve knee loading after ACL reconstruction. This study measured associations at one time point and did not test any intervention.