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Does meniscal pathology alter gait knee biomechanics and strength post-ACL reconstruction?

  • Knee
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

Individuals following anterior cruciate ligament reconstruction (ACLR) with concomitant meniscal pathology have a higher risk of developing knee osteoarthritis (OA) compared to those with isolated ACLR. Knee extensor weakness and altered dynamic knee joint biomechanics have been suggested to play a role in the development of knee OA following ACLR. This study investigated whether these factors differ in people following ACLR who have concomitant meniscal pathology compared to patients with isolated ACLR.

Methods

Thirty-three patients with isolated ACLR and 34 patients with ACLR and meniscal pathology underwent strength and gait assessment 12–24 months post-operatively. Primary measures were peak isometric knee extensor torque and knee adduction moment (peak and impulse). Secondary measures included peak knee flexion moment and knee kinematics (sagittal and transverse).

Results

There were no between-group differences in knee extensor strength [mean difference (95 % CI) 0.09 (−0.23 to 0.42) Nm/kg, n.s.], peak knee adduction moment [−0.02 (−0.54 to 0.49) Nm/(BW × HT) %, n.s.] or knee adduction moment impulse [0.01 (−0.15 to 0.17) Nm/(BW × HT) %, p = n.s.]. No between-group differences were found for any secondary measures.

Conclusions

No evidence was found to suggest that the higher prevalence of OA in patients with ACLR and meniscal pathology compared to patients with isolated ACLR is attributed to reduced knee muscle strength or altered knee joint biomechanics assessed 1–2 years post-surgery. Given that there is a higher incidence of knee OA in patients with concomitant meniscal pathology and ACLR, further investigation is needed so that population-specific rehabilitation protocols can be developed.

Level of evidence

III.

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Acknowledgments

M.H. is supported by National Health and Medical Research Council (NHMRC) programme Grant (#631717), and L.P. was a recipient of an NHMRC postgraduate scholarship. A/Professor A.L.B. is a recipient of the NHMRC Career Development Fellowship (R.D. Wright Biomedical, #1053521). Dr. Clark is a recipient of the NHMRC Career Development Fellowship (R.D..Wright Biomedical, #1090415). The study sponsor did not play any role in the study design, collection, analysis or interpretation of data, nor in the writing of the manuscript or decision to submit the manuscript for publication.

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Authors and Affiliations

  1. Department of Physiotherapy, Centre for Health, Exercise and Sports Medicine, School of Health Sciences, The University of Melbourne, Melbourne, VIC, 3010, Australia

    Michelle Hall, Adam L. Bryant, Tim V. Wrigley, Clare Pratt & Luke G. Perraton

  2. School of Exercise Science, Australian Catholic University, Melbourne, VIC, Australia

    Ross A. Clark & Luke G. Perraton

  3. OrthoSport Victoria, Epworth HealthCare, Richmond, VIC, Australia

    Tim S. Whitehead

  4. The Park Clinic, Gipps Street, East Melbourne, VIC, Australia

    Hayden G. Morris

  5. School of Allied Health, La Trobe University, Melbourne, VIC, Australia

    Kay M. Crossley

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  1. Michelle Hall
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Correspondence to Michelle Hall.

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Hall, M., Bryant, A.L., Wrigley, T.V. et al. Does meniscal pathology alter gait knee biomechanics and strength post-ACL reconstruction?. Knee Surg Sports Traumatol Arthrosc 24, 1501–1509 (2016). https://doi.org/10.1007/s00167-015-3908-x

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  • DOI: https://doi.org/10.1007/s00167-015-3908-x

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