title: Gait Asymmetries Persist 1 Year After Anterior Cruciate Ligament Reconstruction.
abstract: BACKGROUND
  After anterior cruciate ligament reconstruction (ACLR), motivation to return to previous levels of activity is high. Very few studies have used return-to-activity criteria to determine when to permit athletic play. Return-to-activity measures objectively evaluate functional limb symmetry; however, previous biomechanical studies have found gait deviations in these individuals that persist up to 2 years after surgery.
  
  
  OBJECTIVE
  To evaluate gait biomechanics in a specific cohort of ACL patients 1 year after surgery and retrospectively compare individuals who pass return-to-activity criteria 6 months after surgery with those who fail.
  
  
  METHODS
  Prospective analysis.
  
  
  METHODS
  A total of 40 athletes who participated regularly (>50 h/y) in cutting, jumping, and pivoting activities and who sustained an isolated, unilateral ACL rupture were included in this study. All participants underwent reconstruction by the same surgeon and received individualized postoperative rehabilitation. Performance-based and self-report data were measured 6 months after surgery to assess readiness to return to activity (90% outcome required to pass); 20 subjects passed return-to-activity criteria and 20 subjects did not. Motion analysis was performed 1 year after surgery, and knee flexion angles, moments, and excursions were measured during gait and evaluated for all subjects.
  
  
  RESULTS
  There was no limb × group interaction or effect of group for all measures. Decreased knee measures were seen on the involved limb compared with the uninvolved limb for all subjects, and failed subjects demonstrated larger differences between limbs.
  
  
  CONCLUSIONS
  Patients continued to demonstrate biomechanical limb asymmetries 1 year after ACLR, regardless of performance-based measures at 6 months. Early return to activity did not ensure limb symmetry at 1 year.
  
  
  CONCLUSIONS
  Gait asymmetries were seen in all subjects 1 year after surgery regardless of status at 6 months. Potentially prolonging athlete's timelines for returning to activity may prove beneficial for a successful return to activity as well as for long-term knee function.
authors: Investigation performed at the Physical Therapy Department, University of Delaware, Newark, Delaware, USA.
authors: Kathleen
authors: K
authors: White
authors: Investigation performed at the Physical Therapy Department, University of Delaware, Newark, Delaware, USA.
authors: David
authors: D
authors: Logerstedt
authors: Investigation performed at the Physical Therapy Department, University of Delaware, Newark, Delaware, USA.
authors: Lynn
authors: L
authors: Snyder-Mackler
keywords: anterior cruciate ligament; gait biomechanics; knee flexion angle; return to activity