title: Gait adaptations following multiple-ligament knee reconstruction occur with altered knee kinematics during level walking.
abstract: OBJECTIVE
  The biomechanical behaviour of the knee following multiple-ligament reconstruction (MLKR) may play a role in the pathogenesis of post-traumatic osteoarthritis. The aim of this study was to compare three-dimensional knee kinematics and gait characteristics of MLKR patients to healthy controls during level walking.
  
  
  METHODS
  Three-dimensional optoelectronic motion capture during overground walking was performed on 16 patients with MLKR and a group of healthy controls matched individually to each patient for age, gender, height and weight. Three-dimensional knee angles were extracted from the weight acceptance and propulsion sub-phases of gait. Statistical analysis was performed using group-aggregated data, as well as for each patient-control pair using a single-case approach.
  
  
  RESULTS
  Although group analysis detected few differences, single-case analysis revealed significant differences for a proportion of patients for all dependent variables during weight acceptance and propulsion sub-phases of stance. These kinematic differences occurred in the context of reduced gait velocity, step length and cadence, as well as increased time spent in double support.
  
  
  CONCLUSIONS
  Patients with MLKR display abnormalities in knee kinematics during gait at an average of 4.5 years after surgery. The pattern of kinematic abnormalities appears individual specific and may not be related to differences in spatiotemporal gait characteristics. The current findings describe detailed functional outcomes of MLKR reconstruction at average medium-term follow-up that provide improved prognostic information for clinicians to counsel patients with these types of injuries.
authors.affiliation: Sydney Orthopaedic Research Institute, Level 1, 445 Victoria Avenue, Chatswood, NSW, Australia. cscholes@sori.com.au.
authors.forename: Corey J
authors.initials: CJ
authors.lastname: Scholes
authors.affiliation: Sydney Orthopaedic Research Institute, Level 1, 445 Victoria Avenue, Chatswood, NSW, Australia.
authors.forename: Joe T
authors.initials: JT
authors.lastname: Lynch
authors.affiliation: Sydney Orthopaedic Research Institute, Level 1, 445 Victoria Avenue, Chatswood, NSW, Australia.
authors.forename: Milad
authors.initials: M
authors.lastname: Ebrahimi
authors.affiliation: Sydney Orthopaedic Research Institute, Level 1, 445 Victoria Avenue, Chatswood, NSW, Australia.
authors.forename: Brett A
authors.initials: BA
authors.lastname: Fritsch
authors.affiliation: Sydney Orthopaedic Research Institute, Level 1, 445 Victoria Avenue, Chatswood, NSW, Australia.
authors.forename: David A
authors.initials: DA
authors.lastname: Parker
mesh_terms: D000222:Adaptation, Physiological; D000328:Adult; D001696:Biomechanical Phenomena; D005260:Female; D005684:Gait / Q000502:physiology*; D006801:Humans; D021621:Imaging, Three-Dimensional; D007717:Knee / Q000601:surgery; D007718:Knee Injuries / Q000503:physiopathology* / Q000534:rehabilitation / Q000601:surgery; D007719:Knee Joint / Q000503:physiopathology / Q000601:surgery; D008023:Ligaments, Articular / Q000293:injuries* / Q000503:physiopathology* / Q000601:surgery; D008297:Male; D009048:Motor Skills / Q000502:physiology*; D016059:Range of Motion, Articular; D019651:Plastic Surgery Procedures / Q000534:rehabilitation; D012189:Retrospective Studies; D013647:Task Performance and Analysis; D016138:Walking / Q000502:physiology
keywords: Gait; Knee; Multiple-ligament reconstruction; Single-case; Stance; Variability