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Updated: Mar 20, 2026

Author Spotlight: Implementing the Enhanced Recovery After Surgery Concept in Rehabilitation Following Anterior Cruciate Ligament Reconstruction
Published on: March 1, 2024
KNEE SYNERGISM DURING GAIT REMAIN ALTERED ONE YEAR AFTER ACL RECONSTRUCTION
Gustavo Leporace1, Leonardo Metsavaht1, Glauber Ribeiro Pereira1
1. Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
Objective:
To compare the activation of the vastus lateralis (VL) and biceps femoris (BF) muscles during gait, as well VL/BF muscular co-contraction (MCC) between healthy (CG) and anterior cruciate ligament reconstructed (ACL-R) subjects.
Methods:
Nineteen subjects, ten controls and nine ACL-R patients had a VL and BF electromyogram (EMG) captured to calculate the MCC ratio. A Principal Component (PC) Analysis was applied to reduce the dimensionality effect of each of the MCC, VL and BF curves for both healthy and ACL reconstructed groups. The PC scores were used to calculate the standard distance (SD). SD values were employed in order to compare each dependent variable (MCC, VL and BF) between the two groups using unpaired t-test.
Results:
ACL-R group presented a lower VL activation at the beginning and at the end of the gait cycle, as compared to the control group. However, no difference was found for BF or VL/BF MCC.
Conclusion:
The gait analysis of ACL reconstructed patients demonstrated a persistent deficit in VL activation when compared to the control group, even one year after surgery. Level of Evidence III. Case Control Study.
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