Three-Dimensional Kinematic Gait Analysis in Pediatric Patients With an ACL-Deficient Knee

Area of Science:

• Orthopedics
• Sports Medicine
• Biomechanical Analysis

Background:

• Pediatric anterior cruciate ligament (ACL) tears are rising in young athletes.
• Limited biomechanical data exists for pediatric ACL-deficient (ACLD) knees, often relying on adult protocols.
• Knee kinesiography (KKG) offers a clinically accessible tool for gait analysis.

Purpose of the Study:

• To characterize gait-related knee kinematic differences in all three anatomic planes for pediatric ACLD knees during walking.
• To compare gait patterns between ACLD knees, contralateral knees, and healthy controls.
• To identify pediatric-specific gait alterations distinct from adult patterns.

Main Methods:

• Retrospective, single-center study analyzing KKG data from pediatric patients with ACLD knees and healthy controls.
• Kinematic data collected in sagittal, frontal, and transverse planes using KKG.
• Statistical Parametric Mapping 1D used for analysis, with comparisons between ACLD, contralateral, and control knees, and by sex.

Main Results:

• ACLD knees exhibited greater stance flexion (15.1° vs 9.4°) and increased external tibial rotation (1.9° vs -0.1°) compared to controls.
• Contralateral knees also showed greater flexion (12.6° vs 9.4°) and anterior translation at heel strike, indicating bilateral gait modifications.
• No significant differences were observed in the frontal plane or anteroposterior translation, and no sex differences were found.

Conclusions:

• Pediatric ACLD knees demonstrate a flexed-knee gait and increased external tibial rotation, differing from adult patterns.
• Bilateral gait pattern differences underscore the need for comprehensive evaluation and pediatric-specific rehabilitation.
• Findings advocate for tailored strategies over adult-derived protocols for pediatric ACL injury management.