What Are the Criteria for an Acute Form of Anterior Cruciate Ligament Tear for the Severity of the Process by Gait Analysis Data?

Abstract

Purpose: There is still controversy over the criteria for acute ACL tear. In this paper, knee joint function and walking were considered possible ones.

Method: The study included 21 subjects with acute ACL tear and 20 healthy volunteers as a control group. Biomechanical gait analysis was performed using the inertial sensor system including EMG recording. All subjects (but for controls) were divided into two groups: Group 1-"up to 4 weeks" and Group 2-"from 4 weeks to 3 months".

Results: Temporal gait parameters in subjects from Group 1 demonstrate the asymmetry of 4% and more in terms of the gait cycle with a decrease in the affected limb, and are within normal range in Group 2. The amplitudes at the hip and knee joints in the affected limb are reduced which is especially pronounced in Group 1 (2-4 and 6-10 degrees, respectively). The affected knee joint shows a decrease in the range of motion by up to 5 degrees in the first half of the stance phase and flexion by less than 40 degrees in the swing phase. The tibialis anterior and quadriceps femoris muscle function is decreased in the affected limb only in Group 1 (72% and 78% from normal, respectively).

Conclusions: The severity of the condition after an ACL tear is largely determined by functional changes. The time factor is of secondary importance.

Keywords: acute form; anterior cruciate ligament tear; gait analysis; knee joint.

Figure 1

The subject during the examination as per the method with registration in the hip and knee joints, and EMG of the main flexor–extensor muscles.

Figure 2

Goniograms of the hip and knee joints of subjects 1 and 2 (the left limb is affected). Blue line—left side, yellow—right side. The vertical scale is in degrees; the horizontal scale is % of GC. Subject 1–4 days after injury; used crutches. Subject 2–6 days after injury.

Figure 3

Goniograms of the hip and knee joints of subjects 3 and 4. Blue line—left side, yellow—right side. Aff., affected limb; Int., intact limb; vertical scale in degrees; horizontal scale in % of GC.