title: Does meniscal pathology alter gait knee biomechanics and strength post-ACL reconstruction?
abstract: OBJECTIVE
  Individuals following anterior cruciate ligament reconstruction (ACLR) with concomitant meniscal pathology have a higher risk of developing knee osteoarthritis (OA) compared to those with isolated ACLR. Knee extensor weakness and altered dynamic knee joint biomechanics have been suggested to play a role in the development of knee OA following ACLR. This study investigated whether these factors differ in people following ACLR who have concomitant meniscal pathology compared to patients with isolated ACLR.
  
  
  METHODS
  Thirty-three patients with isolated ACLR and 34 patients with ACLR and meniscal pathology underwent strength and gait assessment 12-24 months post-operatively. Primary measures were peak isometric knee extensor torque and knee adduction moment (peak and impulse). Secondary measures included peak knee flexion moment and knee kinematics (sagittal and transverse).
  
  
  RESULTS
  There were no between-group differences in knee extensor strength [mean difference (95 % CI) 0.09 (-0.23 to 0.42) Nm/kg, n.s.], peak knee adduction moment [-0.02 (-0.54 to 0.49) Nm/(BW × HT) %, n.s.] or knee adduction moment impulse [0.01 (-0.15 to 0.17) Nm/(BW × HT) %, p = n.s.]. No between-group differences were found for any secondary measures.
  
  
  CONCLUSIONS
  No evidence was found to suggest that the higher prevalence of OA in patients with ACLR and meniscal pathology compared to patients with isolated ACLR is attributed to reduced knee muscle strength or altered knee joint biomechanics assessed 1-2 years post-surgery. Given that there is a higher incidence of knee OA in patients with concomitant meniscal pathology and ACLR, further investigation is needed so that population-specific rehabilitation protocols can be developed.
  
  
  METHODS
  III.
authors.affiliation: Department of Physiotherapy, Centre for Health, Exercise and Sports Medicine, School of Health Sciences, The University of Melbourne, Melbourne, VIC, 3010, Australia. halm@unimelb.edu.au.
authors.forename: Michelle
authors.initials: M
authors.lastname: Hall
authors.affiliation: Department of Physiotherapy, Centre for Health, Exercise and Sports Medicine, School of Health Sciences, The University of Melbourne, Melbourne, VIC, 3010, Australia.
authors.forename: Adam L
authors.initials: AL
authors.lastname: Bryant
authors.affiliation: Department of Physiotherapy, Centre for Health, Exercise and Sports Medicine, School of Health Sciences, The University of Melbourne, Melbourne, VIC, 3010, Australia.
authors.forename: Tim V
authors.initials: TV
authors.lastname: Wrigley
authors.affiliation: Department of Physiotherapy, Centre for Health, Exercise and Sports Medicine, School of Health Sciences, The University of Melbourne, Melbourne, VIC, 3010, Australia.
authors.forename: Clare
authors.initials: C
authors.lastname: Pratt
authors.affiliation: School of Allied Health, La Trobe University, Melbourne, VIC, Australia.
authors.forename: Kay M
authors.initials: KM
authors.lastname: Crossley
authors.affiliation: OrthoSport Victoria, Epworth HealthCare, Richmond, VIC, Australia.
authors.forename: Tim S
authors.initials: TS
authors.lastname: Whitehead
authors.affiliation: The Park Clinic, Gipps Street, East Melbourne, VIC, Australia.
authors.forename: Hayden G
authors.initials: HG
authors.lastname: Morris
authors.affiliation: School of Exercise Science, Australian Catholic University, Melbourne, VIC, Australia.
authors.forename: Ross A
authors.initials: RA
authors.lastname: Clark
authors.affiliation: Department of Physiotherapy, Centre for Health, Exercise and Sports Medicine, School of Health Sciences, The University of Melbourne, Melbourne, VIC, 3010, Australia.|School of Exercise Science, Australian Catholic University, Melbourne, VIC, Australia.
authors.forename: Luke G
authors.initials: LG
authors.lastname: Perraton
mesh_terms: D000328:Adult; D016118:Anterior Cruciate Ligament / Q000601:surgery; D000070598:Anterior Cruciate Ligament Injuries / Q000150:complications / Q000503:physiopathology* / Q000601:surgery; D059549:Anterior Cruciate Ligament Reconstruction / Q000534:rehabilitation*; D001696:Biomechanical Phenomena; D005260:Female; D005684:Gait / Q000502:physiology*; D006801:Humans; D007718:Knee Injuries / Q000503:physiopathology / Q000601:surgery; D007719:Knee Joint / Q000503:physiopathology* / Q000601:surgery; D008297:Male; D008592:Menisci, Tibial / Q000473:pathology*; D053580:Muscle Strength / Q000502:physiology; D020370:Osteoarthritis, Knee / Q000209:etiology / Q000503:physiopathology / Q000601:surgery; D000070600:Tibial Meniscus Injuries / Q000150:complications / Q000503:physiopathology* / Q000601:surgery; D055815:Young Adult
keywords: Anterior cruciate ligament reconstruction; Knee moments; Meniscus; Strength