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Gait mechanics 2 years after anterior cruciate ligament reconstruction are associated with longer‐term changes in patient‐reported outcomes
Author(s) -
ErhartHledik Jennifer C.,
Chu Constance R.,
Asay Jessica L.,
Andriacchi Thomas P.
Publication year - 2017
Publication title -
journal of orthopaedic research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.041
H-Index - 155
eISSN - 1554-527X
pISSN - 0736-0266
DOI - 10.1002/jor.23317
Subject(s) - medicine , anterior cruciate ligament reconstruction , anterior cruciate ligament , knee pain , gait , gait analysis , surgery , physical medicine and rehabilitation , osteoarthritis , alternative medicine , pathology
This study tested the hypothesis that side‐to‐side differences in knee gait mechanics 2 years after anterior cruciate ligament (ACL) reconstruction are associated with long‐term (∼8 years post‐reconstruction) changes in patient‐reported outcome scores. Sixteen subjects (5 males; age: 29.1 ± 7.1 years) with primary unilateral ACL reconstruction were gait tested at baseline (2.2 ± 0.3 years post‐ACL reconstruction) and filled out KOOS and Lysholm surveys. At long‐term follow‐up (7.7 ± 0.7 years post‐ACL reconstruction), the same subjects completed KOOS and Lysholm surveys. Pearson correlation coefficients assessed relationships between side‐to‐side differences in kinematics and kinetics at baseline and changes in Lysholm and KOOS Pain/QOL scores from 2 to 8 years post‐ACL reconstruction. Significant associations were seen between greater average varus rotation (Lysholm: R  = −0.654, p  = 0.006) and less anterior femoral displacement (Lysholm: R  = 0.578, p  = 0.019) during stance of the ACL reconstructed knee versus the contralateral knee at baseline and worse follow‐up outcome scores. Significant associations were seen between greater peak knee flexion moment (KOOS Pain: R  = −0.572, p  = 0.026; KOOS QOL: R  = −0.636, p  = 0.011), peak knee adduction moment (Lysholm: R  = −0.582, p  = 0.018; KOOS Pain: R  = −0.742, p  = 0.002; KOOS QOL: R  = −0.551, p  = 0.033), and peak internal rotation moment (Lysholm: R  = 0.525, p  = 0.037; KOOS Pain: R  = 0.815, p  < 0.001; KOOS QOL: R  = 0.777, p  = 0.001) in the ACL reconstructed knee at baseline with worse follow‐up outcomes. The results of this study support the hypotheses that early changes in gait mechanics following ACL reconstruction are associated with longer‐term clinical changes in patient‐reported outcomes, suggesting that biomechanical markers obtained as early as 2 years after ACL reconstruction may be useful to understand clinical outcomes in this population. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:634–640, 2017.

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