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Gait adaptations following multiple-ligament knee reconstruction occur with altered knee kinematics during level walking

Authors
  • Scholes, Corey J.1
  • Lynch, Joe T.1
  • Ebrahimi, Milad1
  • Fritsch, Brett A.1
  • Parker, David A.1
  • 1 Sydney Orthopaedic Research Institute, Level 1, 445 Victoria Avenue, Chatswood, NSW, Australia , Chatswood (Australia)
Type
Published Article
Journal
Knee Surgery Sports Traumatology Arthroscopy
Publisher
Springer-Verlag
Publication Date
Apr 16, 2016
Volume
25
Issue
5
Pages
1489–1499
Identifiers
DOI: 10.1007/s00167-016-4104-3
Source
Springer Nature
Keywords
License
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Abstract

PurposeThe 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.MethodsThree-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.ResultsAlthough 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.ConclusionPatients 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.

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