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Updated: Feb 15, 2026

Author Spotlight: Implementing the Enhanced Recovery After Surgery Concept in Rehabilitation Following Anterior Cruciate Ligament Reconstruction
Published on: March 1, 2024
Limb asymmetry during recovery from anterior cruciate ligament reconstruction
Kristen E Renner1, Christopher T Franck2, Thomas K Miller3
1Kevin P. Granata Biomechanics Lab, Biomedical Engineering and Mechanics, Virginia Tech, 495 Old Turner Street, Norris Hall, Room 230, Blacksburg, Virginia, 24061.
Abstract:
There is limited literature that follows a population of Anterior Cruciate Ligament Reconstruction (ACLR) patients through recovery. Our aim was to examine differences in movement and loading patterns across time and between limbs over four visits during 12 months post-ACLR. We hypothesized that kinematic and kinetic data during a stop-jump would have time- and limb-dependent differences through 12 months post-surgery. Twenty-three ACLR athletes performed five vertical stop-jumps at 4, 5, 6, and 12 months post-op with motion capture and force plate data collection. The peak knee flexion (PKF) was different between the 4 and 12, 5 and 6, and the 5 and 12 month visits with earlier months exhibiting higher PKF. The peak vertical ground reaction force (vGRF) was lower at 4 than at 5 and 6 months. The peak posterior ground reaction force (pGRF) was lower at 4 months than all other visits. Frontal knee and sagittal hip range of motion (ROM) were different between 12 months and each previous visit. Asymmetries were present in peak vGRF, peak knee extension moment and impulse up to 12 months. The loading rate and peak pGRF demonstrated between limb differences up to 6 months; limb stiffness demonstrated differences up to 5 months post-ACLR. PKF was only asymmetric at the 4 month visit. While some variables improved in the 12 months post-ACLR, limb asymmetries in peak knee extension moment, peak vGRF and impulse persisted up to 12 months. Additionally, frontal plane knee and sagittal hip ROM had not normalized at 12 months. © 2018 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 36:1887-1893, 2018.
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