SAGITTAL PLANE KINEMATICS OF THE ANTERIOR CRUCIATE LIGAMENT INTACT AND DEFICIENT KNEE DURING OPEN AND CLOSED KINETIC CHAIN EXERCISE

D L Isaac; D J Beard; A J Price; D Murray

doi:10.1302/0301-620X.84BSUPP_III.0840320a

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SAGITTAL PLANE KINEMATICS OF THE ANTERIOR CRUCIATE LIGAMENT INTACT AND DEFICIENT KNEE DURING OPEN AND CLOSED KINETIC CHAIN EXERCISE

D L Isaac
D J Beard
A J Price
D Murray

SAGITTAL PLANE KINEMATICS OF THE ANTERIOR CRUCIATE LIGAMENT INTACT AND DEFICIENT KNEE DURING OPEN AND CLOSED KINETIC CHAIN EXERCISE

Isaac DL, Beard DJ, Price AJ, Murray D. SAGITTAL PLANE KINEMATICS OF THE ANTERIOR CRUCIATE LIGAMENT INTACT AND DEFICIENT KNEE DURING OPEN AND CLOSED KINETIC CHAIN EXERCISE. Orthop Procs. 2002;84-B(SUPP_III):320-320. doi:10.1302/0301-620X.84BSUPP_III.0840320a

Isaac, D L, et al. “SAGITTAL PLANE KINEMATICS OF THE ANTERIOR CRUCIATE LIGAMENT INTACT AND DEFICIENT KNEE DURING OPEN AND CLOSED KINETIC CHAIN EXERCISE.” Orthopaedic Proceedings, vol. 84-B, no. SUPP_III, 2002, pp. 320-320., https://doi.org/10.1302/0301-620X.84BSUPP_III.0840320a

Isaac, D. L., Beard, D. J., Price, A. J., & Murray, D. (2002). SAGITTAL PLANE KINEMATICS OF THE ANTERIOR CRUCIATE LIGAMENT INTACT AND DEFICIENT KNEE DURING OPEN AND CLOSED KINETIC CHAIN EXERCISE. Orthopaedic Proceedings, 84-B(SUPP_III), 320-320. https://doi.org/10.1302/0301-620X.84BSUPP_III.0840320a

Isaac, D. L., Beard, D. J., Price, A. J. and Murray, D. (2002) “SAGITTAL PLANE KINEMATICS OF THE ANTERIOR CRUCIATE LIGAMENT INTACT AND DEFICIENT KNEE DURING OPEN AND CLOSED KINETIC CHAIN EXERCISE.” Orthopaedic Proceedings, 84-B(SUPP_III), pp. 320-320. Available at: https://doi.org/10.1302/0301-620X.84BSUPP_III.0840320a

Isaac, D L, D J Beard, A J Price, and D Murray. “SAGITTAL PLANE KINEMATICS OF THE ANTERIOR CRUCIATE LIGAMENT INTACT AND DEFICIENT KNEE DURING OPEN AND CLOSED KINETIC CHAIN EXERCISE.” Orthopaedic Proceedings 84-B, no. SUPP_III (2002): 320-320. https://doi.org/10.1302/0301-620X.84BSUPP_III.0840320a

Isaac DL, Beard DJ, Price AJ, Murray D. SAGITTAL PLANE KINEMATICS OF THE ANTERIOR CRUCIATE LIGAMENT INTACT AND DEFICIENT KNEE DURING OPEN AND CLOSED KINETIC CHAIN EXERCISE. Orthop Procs. 2002 Nov 1;84-B(SUPP_III):320-320. https://doi.org/10.1302/0301-620X.84BSUPP_III.0840320a

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Abstract

Aim: This study was designed to investigate the nature and extent of tibial translation (TT) during open kinetic chain (OKC) and closed kinetic chain (CKC) activity; recent reports have suggested that the anterior cruciate ligament (ACL) may be strained to an equal amount during CKC and OKC exercise.

Method: Fifteen unilaterally ACL deficient (ACLD) patients and six control subjects underwent fluoroscopic assessment while performing a passive extension exercise, an OKC resisted extension exercise, and a weight-bearing CKC exercise designed to reflect knee motion experienced during dynamic daily activity. Measurements of the patella tendon angle (the angle between the long axis of the tibia and the patella tendon) were obtained to calculate relative TT.

Results: The results show that in ACL intact (ACLI) knees the CKC exercise caused greater anterior TT than the OKC exercise from 0 to 60° of knee flexion (p< 0.05). No difference between ACLI and ACLD knees was detected during the CKC exercise. Maximum weight-bearing (CKC) TT was 8±3 mm. The ACLD tibia during the OKC exercise translated more than the ACLI tibia, and to the same extent as the CKC exercise at 10 to 200 of knee flexion. The ACLI tibia during OKC exercise translated to a maximum of 3±4 mm at 1 0° knee flexion.

Summary: This study has demonstrated that fluoroscopic analysis may be used to detect differences in the kinematics of ACLI and ACLD limbs during activity. It validates recent data demonstrating that the ACL may be strained during CKC exercise to an equal or greater amount than during OKC exercise, and shows that the ACLD knee kinematics are similar to the ACLI knee during CKC exercise. Factors other than the ACL may control the extent of maximal TT during weightbearing activity. This has important consequences for the development of rehabilitation regimes after ACL reconstruction. The commonly held assumption that CKC exercise will protect an ACL graft may not be valid.

The abstracts were prepared by Mr Roger Smith. Correspondence should be addressed to him care of the British Orthopaedic Association, Royal College of Surgeons, 35-43 Lincoln’s Inn Fields, London WC2A 3PN.