Gait adaptations following anterior cruciate ligament rupture are sex specific
Kim Lefebvre1, Clémence Delestre1, Neila Mezghani2
1Laboratoire d'innovation ouverte (LIO), École de technologie supérieure, 1100 Notre-Dame Ouest, Montréal, Québec H3C 1K3, Canada.
Background:
Various gait kinematic adaptations have been reported for patients with an anterior cruciate ligament deficient (ACLD) knee. However, to our knowledge, no study has compared their kinematics to their sex-matched controls for the entire gait cycle. Therefore, this retrospective study aims to identify differences in gait kinematics between ACLD patients and sex-matched controls.
Methods:
Two databases were merged in this study, comparing knee gait kinematics of 44 injured males (ACLD-M) and 27 injured females (ACLD-F) with 32 healthy males (Control-M) and 37 healthy females (Control-F), respectively. Participants walked on a treadmill at a comfortable speed, and their movements were captured using the KneeKG® system.
Results:
The ACLD-M group showed a significantly decreased varus angle at several gait cycle sub-phases (from 17-32%, 57-73% and 86-97%; all p < 0.05) and an increased external tibial rotation from 67-86% of the gait cycle (p < 0.001) compared to the Control-M group. The ACLD-F group exhibited increased knee flexion from 1-53% (p < 0.001) and from 95-100% (p < 0.05) and increased valgus from 1-65% (p < 0.001) and from 94-100% (p < 0.05) of the gait cycle compared to Control-F group.
Conclusion:
Our study reveals sex-specific adaptations following ACL rupture. Women exhibited more gait adaption in the sagittal and frontal planes during the stance phase while men demonstrated adaptations in frontal plane for sub-phases of stance and swing, and external tibial rotation during initial and mid-swing phases. These findings suggest that ACL injury kinematics and rehabilitation after injury should be sex-specific.
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