Differences in landing biomechanics between adolescent athletes with anterior knee pain and healthy controls

The aim of this study was to identify differences in the landing biomechanics of adolescent athletes with anterior knee pain (AKP) compared with healthy controls.

Ten adolescent athletes with AKP and 10 healthy controls performed landing tasks in order to analyze 3D lower-extremity joint angles, moment, and power, ground reaction force (GRF), and vertical stiffness. Time-series data were analyzed from initial contact (0%) to the point of maximum knee flexion (100%) using ensemble curve analyses, while discrete points were analyzed using the Mann-Whitney U Test.

The AKP group exhibited greater peak vertical GRF (vGRF), higher loading rates, and shorter time to peak vGRF (P<0.05) compared with controls. Ensemble curve analyses revealed greater vGRF (6-11%) in the AKP group. Sagittal plane examinations revealed the AKP group to have reduced plantar flexion angles (0-2%), dorsiflexion angles (43-100%), plantar flexor moments (11-100%), ankle shock absorption (17-20%, 23-38%, 56-59%), and knee extensor moments (51-89%) in the AKP group. Moreover, the AKP group exhibited greater knee shock absorption (14-18%), hip power generation (10-12%), and hip shock absorption (97-100%). In the frontal plane, AKP was associated with increased evertor moment (1-3%), knee valgus angle (0-6%), and hip abductor moment (6-8%). Transverse plane analysis showed the hip external-rotator moment to be greater (22-24%) among the AKP group.

Our findings demonstrate the effects of AKP on landing biomechanics in adolescent athletes. These insights reveal potential injury mechanisms and may serve as a guide for the development of rehabilitation strategies.