Goto S, Garrison JC, Singleton SB, Dietrich LN, Hannon JP. Effects of Limb Dominance on Patellofemoral Joint Loading During Gait at 12 Weeks After Anterior Cruciate Ligament Reconstruction.
Orthop J Sports Med 2022;
10:23259671221088316. [PMID:
35928177 PMCID:
PMC9344123 DOI:
10.1177/23259671221088316]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 01/21/2022] [Indexed: 11/30/2022] Open
Abstract
Background:
Patellofemoral joint complications have commonly been reported in long-term
outcome studies for anterior cruciate ligament reconstruction (ACLR);
however, the biomechanics in the early phases of rehabilitation that could
be associated with the development of these abnormalities is unclear. Limb
dominance may affect the biomechanics of the knee joint in patients after
ACLR.
Purpose:
To compare knee joint loading between surgical and nonsurgical limbs at 12
weeks postoperatively in patients who underwent ACLR on either their
dominant limb (ACL-D) or nondominant limb (ACL-ND).
Study Design:
Controlled laboratory study.
Methods:
Included were 54 patients (32 ACL-D and 22 ACL-ND). Peak and integrated
patellofemoral joint stress (PFJS), peak patellofemoral joint reaction force
(PFJRF), and peak knee extension moment (KEM) were assessed during the
stance phase of gait while participants walked on a 10-m runway at a
self-selected speed.
Results:
The surgical limb of the ACL-D group had significantly decreased peak PFJS
(P < .001), integrated PFJS (P <
.001), peak PFJRF (P < .001), and peak KEM
(P < .001) compared to the nonsurgical limb. The
surgical limb of the ACL-ND group demonstrated significantly increased peak
PFJS (P = .001), integrated PFJS (P =
.023), peak PFJRF (P < .001), and peak KEM
(P = .001) compared to the nonsurgical limb. For the
surgical limb, the ACL-ND group demonstrated significantly greater peak PFJS
(P < .001), peak PFJRF (P <
.001) , (PFJRF [P<.001]) and peak KEM
(P < .001) than the ACL-D group. For the nonsurgical
limb, the ACL-D group demonstrated greater peak PFJS (P
< .001), integrated PFJS (P = .023), peak PFJRF
(P = .003), and peak KEM (P < .001)
than the ACL-ND group.
Conclusion:
Significantly larger knee joint loading on the surgical limb of the ACL-ND
group and smaller knee joint loading on the surgical limb of the ACL-D group
were observed compared to the contralateral nonsurgical limb, which suggests
that limb dominance has a key role in loading at the knee joint during
gait.
Clinical Relevance:
Altered knee joint loading during gait at 12 weeks after ACLR may lead to the
development of patellofemoral joint abnormalities.
Collapse