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Predictors of knee joint loading after anterior cruciate ligament reconstruction
Author(s) -
Wellsandt Elizabeth,
Khandha Ashutosh,
Manal Kurt,
Axe Michael J.,
Buchanan Thomas S.,
SnyderMackler Lynn
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.23408
Subject(s) - anterior cruciate ligament , medicine , osteoarthritis , acl injury , knee joint , physical medicine and rehabilitation , ground reaction force , physical therapy , surgery , kinematics , alternative medicine , physics , pathology , classical mechanics
Anterior cruciate ligament (ACL) injury results in altered knee joint mechanics which frequently continue even after ACL reconstruction. The persistence of altered mechanical loading of the knee is of concern due to its likely role in the development of post‐traumatic osteoarthritis (OA). Joint contact forces are associated with post‐traumatic OA development, but evaluation of factors influencing the magnitude of contact forces after ACL injury is needed to advance current strategies aimed at preventing post‐traumatic OA. Therefore, the purpose of this study was to identify predictive factors of knee joint contact forces after ACL reconstruction. Thirty athletes completed standard gait analysis with surface electromyography 6 months after ACL reconstruction. An electromyographic‐driven musculoskeletal model was used to estimate joint contact forces. External knee adduction moment was a significant predictor of medial compartment contact forces in both limbs, while vertical ground reaction force and co‐contraction only contributed significantly in the uninvolved limb. The large influence of the knee adduction moment on joint contact forces provides mechanistic clues to understanding the mechanical pathway of post‐traumatic OA after ACL injury. Statement of Clinical Significance: This study provides critical information in improving the understanding of mechanisms influencing the development of post‐traumatic OA after ACL injury. Further work is needed to identify additional driving factors of joint loading in the ACL‐injured limb and develop treatment strategies to avert the deleterious consequences of post‐traumatic OA. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:651–656, 2017.