Tibiofemoral joint kinematics of the anterior cruciate ligament-reconstructed knee during a single-legged hop landing.
BACKGROUND
Abnormal 3-dimensional tibiofemoral joint kinematics have been identified in anterior cruciate ligament-reconstructed knees during functional gait tasks, which is suggested to directly affect risk of knee osteoarthritis. However, the extent to which similar high-risk abnormalities are present during more demanding maneuvers, such as single-legged hopping, is largely unknown.


OBJECTIVE
When performing a single-legged forward hop landing, the reconstructed knee will demonstrate altered sagittal, frontal, and transverse plane kinematics compared with the contralateral limb.


METHODS
Controlled laboratory study.


METHODS
High-speed biplane radiography was used to quantify bilateral 3-dimensional tibiofemoral joint kinematics in 9 subjects with unilaterally reconstructed anterior cruciate ligaments (mean time after surgery, 4 months) during 3 single-legged, forward hop landing trials. Mean subject-based initial foot contact and maximum stance (0-250 ms) values were calculated for each kinematic variable. Two-tailed paired t tests were subsequently applied to examine for the main effect of limb (reconstructed vs contralateral).


RESULTS
The reconstructed knees exhibited significantly greater extension (P = .04), external tibial rotation (P = .006), and medial tibial translation (P = .02) than the contralateral knees at initial contact. Reconstructed knees underwent significantly greater maximum flexion (P = .05), maximum external tibial rotation (P = .01), and maximum anterior tibial translation (P = .02). No significant differences existed between limbs for initial contact (P = .65) or maximum adduction-abduction (P = .55).


CONCLUSIONS
Tibiofemoral joint kinematics of the anterior cruciate ligament-reconstructed knee are significantly different from those of the uninjured contralateral limb during a single-legged hop landing. This altered kinematic profile, in conjunction with the large impact loads associated with hopping, may further contribute to the risk of posttraumatic knee osteoarthritis.


CONCLUSIONS
Returning to sports involving dynamic single-legged landings at 4 months after anterior cruciate ligament reconstruction surgery may contribute to accelerated knee joint degeneration.
Deneweth
Jessica M
JM
Bone and Joint Center, Henry Ford Hospital, Detroit, Michigan, USA. jmden@umich.edu
Bey
Michael J
MJ
McLean
Scott G
SG
Lock
Terrence R
TR
Kolowich
Patricia A
PA
Tashman
Scott
S
D000293:Adolescent; D000328:Adult; D016118:Anterior Cruciate Ligament / Q000601:surgery*; D000070598:Anterior Cruciate Ligament Injuries; D001696:Biomechanical Phenomena; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D007718:Knee Injuries / Q000503:physiopathology* / Q000601:surgery; D007719:Knee Joint / Q000000981:diagnostic imaging / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D009985:Orthopedics; D010780:Photogrammetry; D011184:Postoperative Period; D011859:Radiography; D012399:Rotation; D055815:Young Adult