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Knee Joint

Knee Joint

The knee joint is the most complicated joint in the body. It consists of three articulations– two tibiofemoral and one patellofemoral. As is characteristic of synovial joints, the knee joint has a thin articular capsule that partially surrounds this joint cavity. Additionally, several ligaments, muscles, and cartilaginous structures support the movement of the knee.
A total of seven ligaments support the knee joint. The patellar ligament, which is also attached to the quadriceps femoris...

Ankle Joint

Ankle Joint

The ankle is formed by the talocrural joint (crural = leg). It consists of the articulations between the talus bone of the foot and the distal ends of the tibia and fibula of the leg. The superior aspect of the talus bone is square-shaped and has three areas of articulation. The top of the talus articulates with the inferior tibia. This is the portion of the ankle joint that carries the body weight between the leg and foot. The sides of the talus are firmly held in position by the articulations...

Bones of the Lower Limb: Femur and Patella

Bones of the Lower Limb: Femur and Patella

The femur is the body's longest and strongest bone spanning the thigh region. Its head articulates with the acetabulum of the hip bone to form the hip joint. A minor indentation on the medial side of the femoral head, called the fovea capitis, serves as the site of attachment for the ligament of the head of the femur. This weak ligament spans the femur and acetabulum and supports the hip joint. The narrowed region below the head is the neck of the femur. The inclination angle between the...

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Author Spotlight: Implementing the Enhanced Recovery After Surgery Concept in Rehabilitation Following Anterior Cruciate Ligament Reconstruction

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Inter-joint coordination and lower limb support in those with ACL-reconstruction.

Steven A Garcia¹, Derek N Pamukoff², Justin D Dennis³

¹Department of Kinesiology and Nutrition, University of Illinois, Chicago, Chicago, IL, USA.

Journal of Biomechanics

|May 3, 2025

Summary

Individuals after anterior cruciate ligament reconstruction (ACLR) alter walking by increasing ankle and hip movement to compensate for reduced knee support. This coordination strategy helps manage demands on the surgical limb during walking.

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Area of Science:

Biomechanics
Orthopedics
Movement Science

Background:

Individuals with anterior cruciate ligament reconstruction (ACLR) exhibit altered gait patterns.
Support demands are shifted away from the surgical knee, potentially requiring compensatory ankle or hip actions.

Purpose of the Study:

To compare lower-limb support and inter-joint coordination during walking in individuals with ACLR.
To understand how ACLR patients adapt and coordinate movements to redistribute support demands.

Main Methods:

Evaluated treadmill walking in 28 individuals with ACLR and 20 healthy controls at preferred speed.
Calculated total support moment (TSM) and individual joint contributions using sagittal joint moments.
Assessed inter-joint coordination (ankle-knee, knee-hip) using vector coding during stance phases.

Main Results:

The ACLR limb showed a smaller first peak TSM and greater hip contributions (6%) compared to the contralateral limb.
ACLR limbs exhibited increased ankle motion in early/mid-stance and hip motion in mid-late stance.
Coordination alterations included increased reliance on ankle and knee motions to compensate for knee mechanics.

Conclusions:

Individuals with ACLR demonstrate altered joint coordination strategies during walking.
These strategies involve increased ankle and hip contributions to manage support and propulsion demands.
Altered coordination may reduce muscular requirements on the surgical limb post-ACLR.