Tine Alkjær1, Marius Henriksen, Erik B Simonsen. 1. Department of Neuroscience and Pharmacology, Division of Biomechanics, University of Copenhagen, 2200, Copenhagen N, Denmark. talkjaer@sund.ku.dk
Abstract
PURPOSE: Rupture of the anterior cruciate ligament (ACL) causes changes in the walking pattern. ACL deficient subjects classified as copers and non-copers have been observed to adopt different post-injury walking patterns. How these different patterns affect the knee compression and shear forces is unresolved. Thus, the aim of the present study was to investigate how different walking patterns observed between copers, non-copers, and controls affect the knee compression and shear forces during walking. METHODS: Three-dimensional gait analyses were performed in copers (n = 9), non-copers (n = 10), and control subjects (n =19). The net knee joint moment, knee joint reaction forces, and the sagittal knee joint angle were input parameters to a biomechanical model that assessed the knee compression and shear forces. RESULTS: The results showed that the non-copers walked with significantly reduced knee compression and shear forces than the controls. The overall knee compression force pattern was similar between the copers and controls, although this variable was significantly increased at heel strike in the copers compared to both non-copers and controls. The peak shear force was significantly dependent on the peak knee extensor moment. This covariance was significantly different between groups meaning that at a given knee extensor moment the shear force was significantly reduced in the copers compared to controls. CONCLUSION: The different knee joint loading patterns observed between non-copers and copers reflected the different walking strategies adopted by these groups, which may have implications for the knee joint stability. The strategy adopted by the copers may resemble an effective way to stabilize the knee joint during walking after an ACL rupture and that the knee kinematics may play a key role for this strategy. It is clinically relevant to investigate if gait retraining would enable non-copers to walk as copers and thereby improve their knee joint stability.
PURPOSE:Rupture of the anterior cruciate ligament (ACL) causes changes in the walking pattern. ACL deficient subjects classified as copers and non-copers have been observed to adopt different post-injury walking patterns. How these different patterns affect the knee compression and shear forces is unresolved. Thus, the aim of the present study was to investigate how different walking patterns observed between copers, non-copers, and controls affect the knee compression and shear forces during walking. METHODS: Three-dimensional gait analyses were performed in copers (n = 9), non-copers (n = 10), and control subjects (n =19). The net knee joint moment, knee joint reaction forces, and the sagittal knee joint angle were input parameters to a biomechanical model that assessed the knee compression and shear forces. RESULTS: The results showed that the non-copers walked with significantly reduced knee compression and shear forces than the controls. The overall knee compression force pattern was similar between the copers and controls, although this variable was significantly increased at heel strike in the copers compared to both non-copers and controls. The peak shear force was significantly dependent on the peak knee extensor moment. This covariance was significantly different between groups meaning that at a given knee extensor moment the shear force was significantly reduced in the copers compared to controls. CONCLUSION: The different knee joint loading patterns observed between non-copers and copers reflected the different walking strategies adopted by these groups, which may have implications for the knee joint stability. The strategy adopted by the copers may resemble an effective way to stabilize the knee joint during walking after an ACL rupture and that the knee kinematics may play a key role for this strategy. It is clinically relevant to investigate if gait retraining would enable non-copers to walk as copers and thereby improve their knee joint stability.
Authors: Marius Henriksen; Erik B Simonsen; Tine Alkjaer; Hans Lund; Thomas Graven-Nielsen; Bente Danneskiold-Samsøe; Henning Bliddal Journal: Knee Date: 2006-09-29 Impact factor: 2.199
Authors: A L Boerboom; A L Hof; J P Halbertsma; J J van Raaij; W Schenk; R L Diercks; J R van Horn Journal: Knee Surg Sports Traumatol Arthrosc Date: 2001-07 Impact factor: 4.342
Authors: Marius Henriksen; Robin Christensen; Tine Alkjaer; Hans Lund; Erik B Simonsen; Henning Bliddal Journal: Clin Biomech (Bristol, Avon) Date: 2007-11-05 Impact factor: 2.063
Authors: Louise M Thoma; Hege Grindem; David Logerstedt; Michael Axe; Lars Engebretsen; May Arna Risberg; Lynn Snyder-Mackler Journal: Am J Sports Med Date: 2019-02-21 Impact factor: 6.202