Does anterior cruciate ligament reconstruction restore normal knee kinematics?: A prospective MRI analysis over two years.
This prospective study used magnetic resonance imaging to record sagittal plane tibiofemoral kinematics before and after anterior cruciate ligament reconstruction using autologous hamstring graft. Twenty patients with anterior cruciate ligament injuries, performed a closed-chain leg-press while relaxed and against a 150 N load. The tibiofemoral contact patterns between 0 degrees to 90 degrees of knee flexion were recorded by magnetic resonance scans. All measurements were performed pre-operatively and repeated at 12 weeks and two years. Following reconstruction there was a mean passive anterior laxity of 2.1 mm (sd 2.3), as measured using a KT 1000 arthrometer, and the mean Cincinnati score was 90 (sd 11) of 100. Pre-operatively, the medial and lateral contact patterns of the injured knees were located posteriorly on the tibial plateau compared with the healthy contralateral knees (p=0.014), but were no longer different at 12 weeks (p=0.117) or two years postoperatively (p=0.909). However, both reconstructed and healthy contralateral knees showed altered kinematics over time. At two years, the contact pattern showed less posterior translation of the lateral femoral condyle during flexion (p<0.01).
Orthopaedic Surgery, Trauma and Orthopaedic Research Unit, 12A The Canberra Hospital, Yamba Drive, Garran ACT 2605, and School of Physiotherapy, University of Sydney, New South Wales, Australia. jennie.scarvell@canberra.edu.au
J M
JM
Scarvell
P N
PN
Smith
K M
KM
Refshauge
H R
HR
Galloway
K R
KR
Woods
D000328:Adult; D016118:Anterior Cruciate Ligament / Q000473:pathology / Q000601:surgery*; D000070598:Anterior Cruciate Ligament Injuries; D001696:Biomechanical Phenomena; D005080:Exercise Test; D005260:Female; D005269:Femur / Q000473:pathology; D006801:Humans; D007593:Joint Instability / Q000209:etiology / Q000503:physiopathology; D007719:Knee Joint / Q000473:pathology / Q000503:physiopathology*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000637:transplantation; D011446:Prospective Studies; D020127:Recovery of Function; D013977:Tibia / Q000473:pathology; D013997:Time Factors; D016896:Treatment Outcome