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Randomized Controlled Trial
. 2013 Feb 1;46(3):515-20.
doi: 10.1016/j.jbiomech.2012.10.010. Epub 2012 Nov 8.

Three-dimensional knee moments of ACL reconstructed and control subjects during gait, stair ascent, and stair descent

Michael E Zabala  1 , Julien Favre, Sean F Scanlan, Joseph Donahue, Thomas P Andriacchi
Affiliations
Randomized Controlled Trial

Three-dimensional knee moments of ACL reconstructed and control subjects during gait, stair ascent, and stair descent

Michael E Zabala et al. J Biomech. .

Abstract

Changes in knee mechanics following anterior cruciate ligament reconstruction (ACLR) have been implicated as a contributor to the development of premature osteoarthritis (OA). However, changes in ambulatory loading in this population have not been well documented. While the magnitude of the external knee moment vector is a major factor in loading at the knee, there is not a comprehensive understanding of the changes in the individual components of the vector following ACL reconstruction. The purpose of this study was to test for differences in the three components of the external knee moment during walking and stair locomotion between ACLR, contralateral and healthy control knees. Forty-five ACLR and 45 healthy control subjects were tested during walking, stair ascent and descent. ACLR knees had a lower first peak adduction moment than contralateral knees during all three activities. Similarly, additional cases of significant differences between ACLR and contralateral knees consisted of lower peak moments for the ACLR than the contralateral knees. These differences were due to both ACLR and contralateral knees as the ACLR knees indicated lower and the contralateral knees greater peak moments compared to healthy control knees. The results suggest a compensatory change involving greater loading in the contralateral knee, perhaps due to lower loading of the ACLR knee. Further, lower knee moments of the ACLR knee suggest that increased joint loading may not be the initiating factor in the development of OA following ACL reconstruction; but rather previous described kinematic or biological changes might initiate the pathway to knee OA.

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Conflict of interest statement

The authors have no conflict of interest to disclose.

Figures

Figure 1
Figure 1
All three moments and the total moment at the knee during gait, stair ascent, and stair descent for ACLR, contralateral, and control knees. (*) indicates significant difference between ACLR and contralateral, (△) indicates significant difference between contralateral and control, and (†) indicates significant difference between ACLR and control knees.
Figure 2
Figure 2
Differences between the means of contralateral and control knee peak moments, and between the means of ACLR and controls knee peak moments. Asterisk indicates significance (p < 0.0125). Brackets represent 95% confidence intervals for differences between the means.
See this image and copyright information in PMC

References

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