Changes in knee motion pattern after anterior cruciate ligament injury - case report.
BACKGROUND
After an anterior cruciate ligament injury, the contra-lateral non-injured leg has been found to adapt towards the injured leg. Accordingly, in order to study changes in knee motion pattern after an anterior cruciate ligament injury, the ideal is to compare the same leg prior to and after the injury. However, this is very seldom possible. The purpose of the present study was to describe changes in static and dynamic sagittal tibial translation, electromyographic activity and muscle torque relevant to an anterior cruciate ligament tear in one patient evaluated both before and after the injury.


METHODS
A male soccer player was examined 11 weeks before and eight weeks after an anterior cruciate ligament injury. Sagittal tibial translation was measured with the CA-4000 electrogoniometer; statically during Lachman's test, and dynamically during isokinetic muscle testing, one-legged squat and level walking. The electromyographic activity of mm. quadriceps and hamstrings, was registered simultaneously during the one-legged squat test.


RESULTS
Static tibial translation was increased by approximately 2 mm, while dynamic tibial translation was decreased by 0.4 mm at isokinetic testing, 0.9 mm at one-legged squat and 2.4 mm during level walking compared to before the injury. Muscle torque decreased 30% and 35% for the quadriceps and the hamstrings muscle, respectively. The electromyographic activity revealed similar activation levels in quadriceps and a doubled level of activation in hamstring compared to before the injury.


CONCLUSIONS
In spite of an increase in static tibial translation eight weeks after an anterior cruciate ligament injury, the tibial translation decreased during activity, thus indicating that the patient could stiffen the knee in order to protect it against increased shear forces.
Kvist
Joanna
J
Division of Physiotherapy, Department of Health and Society, Faculty of Health Sciences, Linköping University, SE-581 83 Linköping, Sweden. Joanna.Kvist@ihs.liu.se
Good
Lars
L
Tagesson
Sofi
S
D000222:Adaptation, Physiological; D000328:Adult; D016118:Anterior Cruciate Ligament / Q000503:physiopathology*; D000070598:Anterior Cruciate Ligament Injuries; D006801:Humans; D007719:Knee Joint / Q000503:physiopathology*; D008297:Male; D009119:Muscle Contraction; D018482:Muscle, Skeletal / Q000503:physiopathology*; D016059:Range of Motion, Articular