Knee joint biomechanics during gait improve from 3 to 6 months after anterior cruciate ligament reconstruction

Abstract
Gait alterations after anterior cruciate ligament reconstruction (ACLR) are commonly reported and have been linked to posttraumatic osteoarthritis development. While knee gait alterations have been studied at several time points after ACLR, little is known about how these biomechanical variables change earlier than 6 months after surgery, nor is much known about how they differ over the entire stance phase of gait. The purpose of this study was to examine knee gait biomechanical variables over their entire movement pattern through stance at both 3 and 6 months after ACLR and to study the progression of interlimb asymmetry between the two postoperative time points. Thirty-five individuals underwent motion analysis during overground walking 3 (3.2 ± 0.5) and 6 (6.4 ± 0.7) months after ACLR. Knee biomechanical variables were compared between limbs and across time points through 100% of stance using statistical parametric mapping; this included a 2 × 2 (Limb × Time) repeated measures analysis of variance and two-tailed t-tests. Smaller knee joint angles, moments, extensor forces, and medial compartment forces were present in the involved versus uninvolved limb. Interlimb asymmetries were present at both time points but were less prevalent at 6 months. The uninvolved limb's biomechanical variables stayed relatively consistent over time, while the involved limb's trended toward that of the uninvolved limb. Statement of Clinical Significance: Interventions to correct asymmetrical gait patterns after ACLR may need to occur early after surgery and may need to focus on multiple parts of stance phase.
Description
This is the peer reviewed version of the following article: Neal, K, Williams, JR, Alfayyadh, A, et al. Knee joint biomechanics during gait improve from 3 to 6 months after anterior cruciate ligament reconstruction. J Orthop Res. 2022; 1- 14. doi:10.1002/jor.25250, which has been published in final form at https://doi.org/10.1002/jor.25250. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions. This article may not be enhanced, enriched or otherwise transformed into a derivative work, without express permission from Wiley or by statutory rights under applicable legislation. Copyright notices must not be removed, obscured or modified. The article must be linked to Wiley’s version of record on Wiley Online Library and any embedding, framing or otherwise making available the article or pages thereof by third parties from platforms, services and websites other than Wiley Online Library must be prohibited. This article will be embargoed until 01/06/2023.
Keywords
ACLR, gait biomechanics, kinematics and kinetics, knee, statistical parametric mapping
Citation
Neal, K, Williams, JR, Alfayyadh, A, et al. Knee joint biomechanics during gait improve from 3 to 6 months after anterior cruciate ligament reconstruction. J Orthop Res. 2022; 1- 14. doi:10.1002/jor.25250