title: Effect of unstable meniscal injury on three-dimensional knee kinematics during gait in anterior cruciate ligament-deficient patients.
abstract: BACKGROUND
  Our purpose was to clarify the differences of three-dimensional knee kinematics in anterior cruciate ligament (ACL)-deficient patients between with and without meniscal injury using gait analysis.
  
  
  METHODS
  A total of 72 knees in 36 young athletes with primary and unilateral ACL injury, with a mean age of 22 years, participated. Gait analysis was done before surgery. According to the arthroscopic findings, patients were divided into two groups. The patients with an unstable meniscal tear were allocated to the meniscal injury group (ACL+M group), and the patients without a meniscal tear were allocated to the no meniscal injury group (ACL group). In the gait analysis, three-dimensional knee kinematics was evaluated and compared.
  
  
  RESULTS
  The patients in both groups exhibited lower sagittal plane knee excursions and peak knee extension angles on the affected limb than on the unaffected limb during the mid-stance. In terms of the axial plane, a rotation angle was significantly smaller in the affected knees than in the unaffected knees in the ACL group. On the other hand, an opposite phenomenon was observed in the ACL+M group. Moreover, a significantly larger rotation angle in the affected knees during the stance phase and the whole gait cycle was observed in the ACL+M group than in the ACL group.
  
  
  CONCLUSIONS
  Increased rotational motion during the gait was observed in the ACL-deficient knees combined with unstable meniscal injuries. Meniscal condition may be a key factor for compensatory gait mechanics to prevent rotatory instability in ACL-deficient patients patients.
  
  
  METHODS
  III.
authors.affiliation: Department of Orthopedic Surgery, Keio University School of Medicine, Tokyo, Japan. Electronic address: kharatoh@yahoo.co.jp.
authors.forename: Kengo
authors.initials: K
authors.lastname: Harato
authors.affiliation: Department of Orthopedic Surgery, Keio University School of Medicine, Tokyo, Japan.
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Niki
authors.affiliation: Department of Physical Therapy, International University of Health and Welfare, Mita Hospital, Tokyo, Japan.
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Kudo
authors.affiliation: Department of Physical Therapy, International University of Health and Welfare, Mita Hospital, Tokyo, Japan.
authors.forename: Aiko
authors.initials: A
authors.lastname: Sakurai
authors.affiliation: Department of Clinical Biomechanics, Keio University School of Medicine, Tokyo, Japan.
authors.forename: Takeo
authors.initials: T
authors.lastname: Nagura
authors.affiliation: Department of Orthopedic Surgery, Keio University School of Medicine, Tokyo, Japan.
authors.forename: Takayuki
authors.initials: T
authors.lastname: Hasegawa
authors.affiliation: Masumoto Sports Clinic, Tokyo, Japan.
authors.forename: Ko
authors.initials: K
authors.lastname: Masumoto
authors.affiliation: Faculty of Nursing and Medical Care, Keio University, Tokyo, Japan.
authors.forename: Toshiro
authors.initials: T
authors.lastname: Otani
mesh_terms: D000328:Adult; D016118:Anterior Cruciate Ligament / Q000601:surgery; D000070598:Anterior Cruciate Ligament Injuries; D001182:Arthroscopy; D001696:Biomechanical Phenomena / Q000502:physiology; D005260:Female; D005684:Gait / Q000502:physiology*; D006801:Humans; D021621:Imaging, Three-Dimensional; D007593:Joint Instability / Q000503:physiopathology*; D007719:Knee Joint / Q000503:physiopathology*; D008297:Male; D008592:Menisci, Tibial / Q000503:physiopathology / Q000601:surgery; D000070600:Tibial Meniscus Injuries; D055815:Young Adult
keywords: ACL-deficient; Gait analysis; Meniscal injury; Stiffening strategy; Tibial rotation