title: Knee kinematics during stair descent 20 years following anterior cruciate ligament rupture with and without reconstruction.
abstract: BACKGROUND
  Changes and asymmetries for walking gait have been explored extensively following injuries of anterior cruciate ligaments within ten years of injury or reconstruction. We examined longer term knee joint kinematics of reconstructed and non-reconstructed knees during stair descent compared to controls.
  
  
  METHODS
  Three-dimensional knee kinematics during stair descent were registered for 33 subjects with ACL reconstruction, 36 subjects with ACL rupture managed with physiotherapy only and 31 uninjured controls. Injured subjects were 23.5 (2.1) years following injury. Linear mixed models were used to compare temporal variables and knee kinematics during stance phase between groups and contralateral sides.
  
  
  RESULTS
  Walking speed was slower for the both ACL-injured groups compared to controls and stance duration was longer for the injured than the uninjured sides of the physiotherapy-only group. Compared to controls, the physiotherapy-only group had significantly less adduction at initial foot contact of the injured and uninjured knees. The uninjured side of the physiotherapy-only group also had less flexion than controls at initial foot contact and during weight acceptance. Compared to the surgically-managed group, the injured sides of the physiotherapy-only groups had significantly less adduction at initial contact, peak adduction during weight acceptance, and peak flexion during propulsion.
  
  
  CONCLUSIONS
  Independent of treatment, altered knee kinematics exist more than 20 years following ACL injury during stair descent. We suggest that future studies investigating short and long-term kinematic outcomes of ACL injury could evaluate stair descent with particular emphasis on weight acceptance of stance, and potential associations to perceived knee function.
authors.affiliation: Centre for Health, Activity and Rehabilitation Research, School of Physiotherapy, University of Otago, Box 56, Dunedin 9056, New Zealand. Electronic address: gisela.sole@otago.ac.nz.
authors.forename: Gisela
authors.initials: G
authors.lastname: Sole
authors.affiliation: Dept. of Community Medicine and Rehabilitation, Section for Physiotherapy, Umeå University, SE-90187 Umeå, Sweden. Electronic address: eva.tengman@umu.se.
authors.forename: Eva
authors.initials: E
authors.lastname: Tengman
authors.affiliation: Dept. of Community Medicine and Rehabilitation, Section for Physiotherapy, Umeå University, SE-90187 Umeå, Sweden. Electronic address: helena.grip@umu.se.
authors.forename: Helena
authors.initials: H
authors.lastname: Grip
authors.affiliation: Dept. of Community Medicine and Rehabilitation, Section for Physiotherapy, Umeå University, SE-90187 Umeå, Sweden. Electronic address: charlotte.hager@umu.se.
authors.forename: Charlotte K
authors.initials: CK
authors.lastname: Häger
mesh_terms: D000328:Adult; D000070598:Anterior Cruciate Ligament Injuries; D059549:Anterior Cruciate Ligament Reconstruction; D001696:Biomechanical Phenomena; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D005684:Gait; D006801:Humans; D007717:Knee / Q000502:physiology; D007719:Knee Joint / Q000502:physiology / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D016059:Range of Motion, Articular; D012421:Rupture / Q000503:physiopathology; D013180:Sprains and Strains / Q000503:physiopathology / Q000601:surgery*; D016896:Treatment Outcome; D016138:Walking
keywords: Anterior cruciate ligament rupture; Kinematics; Outcomes; Stair ambulation