[Gait analysis associated with anterior cruciate ligament reconstruction].
ABSTRACT To determine how selected gait parameters, measured by three-dimensional To determine how selected gait parameters, measured by three-dimensional motion capture system, may change as a result of anterior cruciate ligament (ACL) deficiency and following ACL reconstruction.
The study was performed on 29 ACL-deficient subjects prior to and at 3, 6, 9 and 12 months after ACL reconstructive surgery by the four stranded hamstring tendon technique. The group was examined at an average of 2.6 months after injury (range: 2 weeks-16 months). But at presurgery, gait analysis was performed using the DorealSoft DVMC-8801 three-dimensional motion capture system. Kinematic data were recorded for the lower extremities. The results obtained from the injured subjects were compared with those of 58 individuals without ACL damage. Each subject was asked to walk on a motorized treadmill (ECON USA) with different slopes and perform-after a 6 minute familiarization time-at least 2 minutes of walking at a constant speed of 1.9 km/h.
The ACL-deficient patients exhibited a quadriceps avoidance pattern prior to and at 3 months post-surgery. In the operated individuals, the spatial-temporal parameters and the knee angle had already regained a normal pattern for the ACL-deficient extremity during gait at 6 months post-surgery. However, the relative ACL movement parameter-which describes the tibial translation into the direction of ACL-and the angular acceleration showed no significant statistical difference as compared with the values of healthy control group at just 9 months post-surgery.
The ACL surgical repair significantly alters lower-extremity gait patterns, and that the establishment of pre-injury gait patterns takes at least 9 months to occur. 3D gait analysis for assessment of patients undergoing anterior cruciate ligament reconstruction surgery can precisely reflect knee biomechanical changes, and assist to explore optimal treatment approach and postoperative rehabilitation methods.
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ABSTRACT: Current clinical outcome measurements may overestimate the long term success of anterior cruciate ligament reconstruction (ACLR). There is a need to understand biomechanics of the knee joint during daily activities. This systematic review provides a comprehensive overview of the literature related to gait in patients following ACLR. The purpose of this systematic review was to investigate the available literature and provide a comprehensive overview of kinematic and kinetic variables that present during gait in patients after ACLR. A literature search was performed in AMED, CINAHL, EMBASE, Medline and Scopus between January 2000 and October 2012. Inclusion criteria included articles written in English, German or Dutch, and those reporting on gait analysis in patients after ACLR. Kinematic and/or kinetic data of the uninjured and ACLR knee and healthy controls (CTRL) were outcome measurements of interest. Each study's methodological quality was assessed using the Critical Appraisal Skills Programme critical appraisal tool. Twenty two studies fulfilled the inclusion criteria. A total of 479 patients with a mean age of 27.3 were examined. Time between the injury and surgery and ranged from 3 weeks to 5.7 years. Gait analysis was done at a mean of 29.3 months after surgery. Gait was found to be altered in the sagittal, frontal and transverse planes after ACLR and may take months or years to normalize, if normalization occurs at all. Patients after ACLR have altered gait patterns that can persist for up to five years after surgery. It is imperative that rehabilitation techniques are examined in order to minimize changes in knee biomechanics during gait, as they have the potential to impact on the development of osteoarthritis. 3a.International journal of sports physical therapy. 08/2013; 8(4):441-51.