Related Experiment Video
Updated: Jun 6, 2026
Early Weight-Bearing Rehabilitation Protocol After Anterior Cruciate Ligament Reconstruction
Published on: March 1, 2024
A Graft Source Comparison of Changes in Walking Gait After Anterior Cruciate Ligament Reconstruction Using
Rachel E Cherelstein1,2, Christopher M Kuenze1,3, Michelle C Walaszek3
1Inova Health System, Fairfax, VA.
Context:
Up to 36% of patients will develop osteoarthritis within a decade of anterior cruciate ligament reconstruction (ACLR), and postoperative changes in gait mechanics have been shown to be associated with radiographic and biochemical markers of cartilage degeneration.
Objectives:
To characterize changes in limb-loading symmetry during walking gait from 6 to 12 months after ACLR in patients with extensor mechanism autografts using force-sensing insoles and to compare the change in limb-loading metrics between patients with bone-patellar tendon-bone (BPTB) and quadriceps tendon (QT) autografts.
Design:
Prospective cohort study.
Setting:
Orthopaedic rehabilitation clinics.
Patients Or Other Participants:
Twenty-seven participants (20 female; 13 BPTB, 14 QT; age = 21.4 ± 6.1 years) who underwent unilateral, primary ACLR with a BPTB or QT autograft.
Main Outcome Measures:
Gait assessment, the International Knee Documentation Committee (IKDC) survey, and the ACL-Return to Sport after Injury (ACL-RSI) survey were completed 6 ± 1 and 12 ± 2 months post-ACLR.
Results:
Participants experienced a significant increase in ACLR limb peak impact force (P = .007), average loading rate (P = .043), and instantaneous loading rate (P = .021) over time, but no significant changes were found in the contralateral limb or limb symmetry index (LSI). No differences were found in the change in LSI for any variable between graft cohorts. Participants experienced a significant improvement in the IKDC score, but the ACL-RSI score did not significantly improve.
Conclusions:
When tested in the clinical environment using force-sensing insoles, an increase in ACLR limb loading occurred from 6 to 12 months post-ACLR, but this change is not affected by autograft source.
