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First published on May 18, 2004, doi:10.1177/0363546503262173
This version was published on July 1, 2004
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The American Journal of Sports Medicine 32:1250-1255 (2004)
© 2004 American Orthopaedic Society for Sports Medicine

Sagittal Plane Translation During Level Walking in Poor-Functioning and Well-Functioning Patients With Anterior Cruciate Ligament Deficiency

Joanna Kvist, RPT, PhD*

From the Institution of Health and Society, Physical Therapy and the Institution of Neuroscience and Locomotion, Linköping, Sweden

* Address correspondence to Joanna Kvist, PhD, Institution of Health and Society, Physical Therapy, 581 83 Linköping, Sweden (e-mail: joanna.kvist{at}ihs.liu.se).

Background: Some patients with anterior cruciate ligament deficiency can function well and participate in high-level sports, whereas others have functional limitations even during activities of daily living.

Hypothesis: Patients who function well after an anterior cruciate ligament injury can stabilize the knee joint during gait by an anterior positioning of the tibia.

Study Design: Controlled laboratory study.

Methods: Sagittal tibial translation was registered with the CA-4000 electrogoniometer, during the Lachman test and walking, in 20 patients with a unilateral anterior cruciate ligament injury. Eleven patients functioned well (Lysholm score ≥84), and 9 patients had poor knee function (Lysholm score <84).

Results: During gait, the well-functioning group had 24% greater anterior translation in the injured leg compared to the noninjured leg. In the poor-functioning group, the anterior translation in the injured leg was 16% smaller compared to the noninjured leg (P = .0003). Tibial translation during the Lachman test was similar in the injured leg in the 2 groups.

Conclusion: Patients who function well position their tibiae near the anterior border of the joint play. This position may encourage functional stability.

Clinical Relevance: Rehabilitation that emphasizes training to stabilize the tibia in an anterior position may improve functional stability of the anterior cruciate ligament–deficient knee.

Key Words: anterior cruciate ligament (ACL) • knee kinematics • functional stability • biomechanics • compensators




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