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Updated: Aug 27, 2025

Author Spotlight: Implementing the Enhanced Recovery After Surgery Concept in Rehabilitation Following Anterior Cruciate Ligament Reconstruction
Published on: March 1, 2024
Detecting side-to-side differences of lower limb biomechanics during single-legged forward landing after anterior
Makoto Asaeda1, Atsuo Nakamae2, Yukio Mikami3
1Sports Medical Center, Hiroshima University Hospital, 1-2-3, Kasumi, Minami-ku, Hiroshima, 734-8551, Japan; Faculty of Wakayama Health Care Sciences, Takarazuka University of Medical and Health Care, 2252, Nakanoshima, Wakayama, 640-8392, Japan.
Background:
Motion analysis can be used to evaluate functional recovery after anterior cruciate ligament (ACL) reconstruction; however, the biomechanics parameters of the lower limb that are specifically altered in ACL-reconstructed knees compared to the contralateral side are not well understood. This retrospective study aimed to compare side-to-side differences in lower limb biomechanics during the first 100 milliseconds (ms) after initial contact in a single-leg forward landing task.
Methods:
Using three-dimensional motion analysis, lower joint kinematic and kinetic variables were measured 8-10 months postoperatively in 22 patients who had undergone ACL reconstruction. We determined side-to-side differences in lower limb biomechanics over the 100-ms timeframe after landing, and receiver operating characteristic (ROC) curve analyses were performed to calculate the area under the curve (AUC) for parameters showing significant side-to-side differences.
Results:
During the 100-ms timeframe after landing, 58 kinematic and kinetic items showed significant side-to-side differences. Side-to-side differences in lower limb biomechanics over the 40-ms timeframe after landing existed. The ROC curve analysis identified 11 items with AUC values ≥ 0.70, including hip flexion, abduction moment, and knee joint power, and their AUC values were not significantly different.
Conclusion:
Hip flexion/abduction moment and knee power after GRF max could be used as outcomes for assessing functional recovery in patients who have undergone ACL reconstruction.

