title: Knee mechanics during landing in anterior cruciate ligament patients: A longitudinal study from pre- to 12 months post-reconstruction.
abstract: BACKGROUND
  Patients with a history of anterior cruciate ligament rupture are at elevated risk of developing knee osteoarthritis. Altered knee kinematics and kinetics during functional activities have been viewed as risk factors for cartilage breakdown and, therefore, one of the primary goals of anterior cruciate ligament reconstruction is to restore knee joint function.
  
  
  METHODS
  Patients' (n=18) knee mechanics while performing a single leg hop for distance were calculated for both legs using a soft-tissue artifact optimized rigid lower-body model at the pre-reconstruction state and six and twelve months after anterior cruciate ligament reconstruction.
  
  
  RESULTS
  Independent of the analyzed time point the involved leg showed a lower external flexion and adduction moment at the knee, and an increased anterior translation and external rotational offset of the shank with respect to the thigh compared to the uninvolved leg. There were no differences for any of the analyzed knee kinematic and kinetic parameters within the control subject group.
  
  
  CONCLUSIONS
  The identified kinematic changes can cause a shift in the normal load-bearing regions of the knee and may support the view that the risk of developing knee osteoarthritis in an anterior cruciate ligament ruptured joint while performing activities involving frequent landing and stopping actions is less likely to be associated with the knee adduction moment and is rather due to kinematic changes. Anterior cruciate ligament reconstruction surgery failed to restore normal knee kinematics during landing, potentially explaining the persistent risk for the development of knee osteoarthritis in patients who have returned to sports following reconstruction surgery.
authors.affiliation: Institute of Biomechanics and Orthopaedics, German Sport University Cologne, Germany; Institute of Movement and Sport Gerontology, German Sport University Cologne, Germany. Electronic address: oberlaender@bme-tech.com.
authors.forename: Kai Daniel
authors.initials: KD
authors.lastname: Oberländer
authors.affiliation: Institute of Biomechanics and Orthopaedics, German Sport University Cologne, Germany; Cologne Center for Musculoskeletal Biomechanics, Medical Faculty, University of Cologne, Germany.
authors.forename: Gert-Peter
authors.initials: GP
authors.lastname: Brüggemann
authors.affiliation: Clinic for Sports Traumatology at Cologne Merheim Medical Center, University of Witten-Herdecke, Germany.
authors.forename: Jürgen
authors.initials: J
authors.lastname: Höher
authors.affiliation: Institute of Biomechanics and Orthopaedics, German Sport University Cologne, Germany; Department of Mathematics and Technology, University of Applied Sciences Koblenz, RheinAhrCampus Remagen, Germany.
authors.forename: Kiros
authors.initials: K
authors.lastname: Karamanidis
mesh_terms: D000328:Adult; D016118:Anterior Cruciate Ligament / Q000503:physiopathology*; D059549:Anterior Cruciate Ligament Reconstruction / Q000534:rehabilitation*; D001696:Biomechanical Phenomena / Q000502:physiology; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D007717:Knee / Q000503:physiopathology; D007718:Knee Injuries / Q000503:physiopathology; D007719:Knee Joint / Q000503:physiopathology*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009068:Movement; D016059:Range of Motion, Articular; D012399:Rotation; D012421:Rupture / Q000503:physiopathology; D013848:Thigh / Q000503:physiopathology; D016474:Weight-Bearing
keywords: Anterior cruciate ligament; Joint kinematics; Osteoarthritis; Reconstruction