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IN VIVO KINEMATICS OF THE ACL-DEFICIENT KNEE DURING RUNNING AND CUTTING



Abstract

Introduction and Aims: Since existing data relating to the kinematics of ACL-deficient knee joints relates mainly to walking, the kinematics during more dynamic activities remains unknown; therefore, the aim of this unique study was to describe in vivo ACL-deficient knee kinematics and muscle activity during running and cutting.

Method: Fifteen subjects with proven unilateral ACL rupture were measured performing running and cutting tasks prior to surgical reconstruction. Gait analysis was used to determine inter-limb differences in displacements at the knee joint during stance phase. Simultaneous EMG analysis was performed to give temporal measures of lower limb muscle activity.

Results: No significant inter-limb difference was seen for tibio-femoral translation in the sagittal or coronal planes during any part of stance phase. The ACLD limb showed a significantly reduced maximum knee flexion angle (40.4 vs. 44.0 degrees) compared to the ACL-intact (ACLI) limb (p=0.04). Internal tibial rotation was significantly greater (7.3 vs. 0.7 degrees) in the ACLD limb at toe-off (p=0.03). The quadriceps muscle group was found to be active for a significantly greater percentage of stance phase in the ACLD limb compared to the ACLI limb (p=0.001).

Conclusion: The ACL-deficient gait involves consistently greater knee extensor activity than ACL-intact gait during running, and as a consequence maximum knee flexion angle is reduced. These findings contrast with the description of ‘quadriceps-avoidance’ gait often described for ACL-deficient subjects. ACL-deficient gait also demonstrates increased rotational instability during terminal stance phase.

These abstracts were prepared by Editorial Secretary, George Sikorski. Correspondence should be addressed to Australian Orthopaedic Association, Ground Floor, The William Bland Centre, 229 Macquarie Street, Sydney, NSW 2000, Australia.

None of the authors is receiving any financial benefit or support from any source.