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From the Bone and Joint Center and the Department of Orthopaedic Surgery, Henry Ford Health System, Detroit, Michigan
* Address correspondence and reprint requests to Scott Tashman, PhD, Bone and Joint Center, ER2015, Henry Ford Health System, Detroit, MI 48202 (e-mail: tashman{at}bjc.hfh.edu).
Background: The effectiveness of anterior cruciate ligament reconstruction for restoring normal knee kinematics is largely unknown, particularly during sports movements generating large, rapidly applied forces.
Hypothesis: Under dynamic in vivo loading, significant differences in 3-dimensional kinematics exist between anterior cruciate ligament–reconstructed knees and the contralateral, uninjured knees.
Study Design: Prospective, in vivo laboratory study.
Methods: Kinematics of anterior cruciate ligament–reconstructed and contralateral (uninjured) knees were evaluated for 6 subjects during downhill running 4 to 12 months after anterior cruciate ligament reconstruction, using a 250 frame/s stereoradiographic system. Anatomical reference axes were determined from computed tomography scans. Kinematic differences between the uninjured and reconstructed limbs were evaluated with a repeated-measures analysis of variance.
Results: Anterior tibial translation was similar for the reconstructed and uninjured limbs. However, reconstructed knees were more externally rotated on average by 3.8 ± 2.3°across all subjects and time points (P = .0011). Reconstructed knees were also more adducted, by an average of 2.8 ± 1.6°(P = .0091). Although differences were small, they were consistent in all subjects.
Conclusions: Anterior cruciate ligament reconstruction failed to restore normal rotational knee kinematics during dynamic loading.
Clinical Relevance: Although further study is required, these abnormal motions may contribute to long-term joint degeneration associated with anterior cruciate ligament injury/reconstruction.
Key Words: knee • anterior cruciate ligament (ACL) • kinematics • reconstruction • running
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