Gait Biomechanics in Anterior Cruciate Ligament-reconstructed Knees at Different Time Frames Postsurgery

To examine knee and hip biomechanics during walking and jogging in groups of ACLR patients at early, mid, and late time frames postsurgery and healthy controls.

Participants included individuals with a history of primary, unilateral ACLR, stratified into early (1.4 ± 0.4 yr post, n = 18), mid (3.3 ± 0.6 yr post, n = 20), and late (8.5 ± 2.8 yr post, n = 20) ACLR groups based on time postsurgery, and a healthy control group (n = 20). Walking and jogging motion capture analysis of knee and hip kinetics and kinematics were measured in the sagittal and frontal planes. Interlimb (within groups) and between-group comparisons were performed for all gait variables. Statistical comparisons were made across the gait cycle by plotting graphs of means and 90% confidence intervals and identifying regions of the gait cycle in which the 90% confidence intervals did not overlap.

Early ACLR group demonstrated reduced knee flexion, knee extension, knee adduction, and hip adduction moments on the ACLR limb. Mid ACLR group demonstrated no gait differences between limbs or other groups. Late ACLR group demonstrated reduced knee flexion moments, and greater knee and hip adduction moments in their ACLR limb. Control group demonstrated no interlimb differences.

Walking and jogging gait biomechanics presented differently in patients at different stages in time after ACLR surgery. The early ACLR group demonstrated lower sagittal and frontal plane joint loading on the ACLR limb compared with contralateral and control limbs. The mid ACLR group did not demonstrate any gait differences compared with the contralateral or control limb. The late ACLR group demonstrated lower sagittal plane joint loading compared with control limbs and greater frontal plane joint loading compared to contralateral and control limbs.