Comparison of Knee Range of Motion and Spatio-Temporal Parameters of Gait in Elite Men Athletes after Anterior Cruciate Ligament Reconstruction Using Two Surgery Methods

Document Type : Original Articles

Authors

1 Assistant Professor of Sport Biomechanics, Department of Physical Education, School of Sport Sciences, Ferdowsi University of Mashhad, Mashhad, Iran

2 PhD in Sports Biomechanics, Department of Biomechanics and Sport Injuries, School of Physical Education and Sport Sciences, Kharazmi University, Tehran, Iran

3 Department of Sport Sciences, School of Physical Education and Sport Sciences, Mashhad Branch, Islamic Azad University, Mashhad, Iran

10.22122/jrrs.v14i2.3173

Abstract

Introduction: The anterior cruciate ligament (ACL) is one of the supporting structures of the knee joint. ACL injuries are very common, and rapid postoperative return to exercise is the most important goal for athletes. Considering the different available surgical approaches, the purpose of the present study was to compare the knee range of motion (ROM) and spatio-temporal parameters during gait after ACL reconstruction using two different surgical methods in elite men athletes.Materials and Methods: In this quasi-experimental study, 25 elite athletes participated, ten subjects in the healthy group, eight in the allograft group, and seven in the autograft group. They were asked to walk along a walkway at preferred speed. Qualisys motion analysis system (eight camera) at a sampling frequency of 100 Hz was used to measure gait kinematic. Spatio-temporal and ROM parameters were extracted in three groups. One-way analysis of variance was performed to compare these variables at a significance level of P < 0.05.Results: There was no significant difference between the groups in terms of spatio-temporal parameters of step length, step time, stride length, stride time, cadence, velocity, stance phase, and swing phase of gait (P > 0.05 for all); however, the allograft group had lower mean values in all variables except for the cadence. In terms of knee ROM, with the exception of the minimum swing flexion that was significantly less in control group (P = 0.01), there was no significant difference between groups (P > 0.05).Conclusion: It seems that there is no functional difference between the two reconstruction types; therefore, it is not possible to make decision about knee reconstruction with regard tospatio-temporal parameters and kinematic pattern. We suggest that knee reconstruction be assessed from different viewpoints such as coordination pattern and muscle coordination.

Keywords

  1. Andersen HN, Dyhre-Poulsen P. The anterior cruciate ligament does play a role in controlling axial rotation in the knee. Knee Surg Sports Traumatol Arthrosc 1997; 5(3): 145-9.
  2. Darrow CJ, Collins CL, Yard EE, Comstock RD. Epidemiology of severe injuries among United States high school athletes: 2005-2007. Am J Sports Med 2009; 37(9): 1798-805.
  3. Bollen S. Epidemiology of knee injuries: Diagnosis and triage. Br J Sports Med 2000; 34(3): 227-8.
  4. Hewett TE, Di Stasi SL, Myer GD. Current concepts for injury prevention in athletes after anterior cruciate ligament reconstruction. Am J Sports Med 2013; 41(1): 216-24.
  5. Kiapour AM, Murray MM. Basic science of anterior cruciate ligament injury and repair. Bone Joint Res 2014; 3(2): 20-31.
  6. Ejerhed L, Kartus J, Sernert N, Kohler K, Karlsson J. Patellar tendon or semitendinosus tendon autografts for anterior cruciate ligament reconstruction? A prospective randomized study with a two-year follow-up. Am J Sports Med 2003; 31(1): 19-25.
  7. Jansson KA, Linko E, Sandelin J, Harilainen A. A prospective randomized study of patellar versus hamstring tendon autografts for anterior cruciate ligament reconstruction. Am J Sports Med 2003; 31(1): 12-8.
  8. Mall NA, Thiel GS, Bedi A, Cole B. Graft selection in anterior cruciate ligament reconstruction [Online]. [cited 2012]; Available from: URL: https://pdfs.semanticscholar.org/7bc3/77044006a0a0302e939334b90fbe56f65db5.pdf
  9. Reinhardt KR, Hetsroni I, Marx RG. Graft selection for anterior cruciate ligament reconstruction: a level I systematic review comparing failure rates and functional outcomes. Orthop Clin North Am 2010; 41(2): 249-62.
  10. Adams D, Logerstedt DS, Hunter-Giordano A, Axe MJ, Snyder-Mackler L. Current concepts for anterior cruciate ligament reconstruction: a criterion-based rehabilitation progression. J Orthop Sports Phys Ther 2012; 42(7): 601-14.
  11. Kowalk DL, Duncan JA, McCue FC 3rd, Vaughan CL. Anterior cruciate ligament reconstruction and joint dynamics during stair climbing. Med Sci Sports Exerc 1997; 29(11): 1406-13.
  12. Leporace G, Batista LA, Muniz AM, Zeitoune G, Luciano T, Metsavaht L, et al. Classification of gait kinematics of anterior cruciate ligament reconstructed subjects using principal component analysis and regressions modelling. Conf Proc IEEE Eng Med Biol Soc 2012; 2012: 6514-7.
  13. Gao B, Zheng NN. Alterations in three-dimensional joint kinematics of anterior cruciate ligament-deficient and -reconstructed knees during walking. Clin Biomech (Bristol, Avon) 2010; 25(3): 222-9.
  14. Howells BE, Ardern CL, Webster KE. Is postural control restored following anterior cruciate ligament reconstruction? A systematic review. Knee Surg Sports Traumatol Arthrosc 2011; 19(7): 1168-77.
  15. Kumar D, Kothari A, Souza RB, Wu S, Benjamin MC, Li X. Frontal plane knee mechanics and medial cartilage MR relaxation times in individuals with ACL reconstruction: A pilot study. Knee 2014; 21(5): 881-5.
  16. Hadizadeh M, Amri S, Roohi SA, Mohafez H. Assessment of Gait Symmetry Improvements in National Athletes after Anterior Cruciate Ligament Reconstruction during Rehabilitation. Int J Sports Med 2016; 37(12): 997-1002.
  17. Di Stasi SL, Logerstedt D, Gardinier ES, Snyder-Mackler L. Gait patterns differ between ACL-reconstructed athletes who pass return-to-sport criteria and those who fail. Am J Sports Med 2013; 41(6): 1310-8.
  18. Luc-Harkey BA, Harkey MS, Stanley LE, Blackburn JT, Padua DA, Pietrosimone B. Sagittal plane kinematics predict kinetics during walking gait in individuals with anterior cruciate ligament reconstruction. Clin Biomech (Bristol , Avon ) 2016; 39: 9-13.
  19. Jerosch J, Prymka M. Proprioception and joint stability. Knee Surg Sports Traumatol Arthrosc 1996; 4(3): 171-9.
  20. Ozenci AM, Inanmaz E, Ozcanli H, Soyuncu Y, Samanci N, Dagseven T, et al. Proprioceptive comparison of allograft and autograft anterior cruciate ligament reconstructions. Knee Surg Sports Traumatol Arthrosc 2007; 15(12): 1432-7.
  21. Ericksen HM, Gribble PA, Pfile KR, Pietrosimone BG. Different modes of feedback and peak vertical ground reaction force during jump landing: a systematic review. J Athl Train 2013; 48(5): 685-95.
  22. Stearns KM, Pollard CD. Abnormal frontal plane knee mechanics during sidestep cutting in female soccer athletes after anterior cruciate ligament reconstruction and return to sport. Am J Sports Med 2013; 41(4): 918-23.
  23. Kaeding CC, Aros B, Pedroza A, Pifel E, Amendola A, Andrish JT, et al. Allograft Versus Autograft Anterior Cruciate Ligament Reconstruction: Predictors of Failure From a MOON Prospective Longitudinal Cohort. Sports Health 2011; 3(1): 73-81.
  24. Peterson RK, Shelton WR, Bomboy AL. Allograft versus autograft patellar tendon anterior cruciate ligament reconstruction: A 5-year follow-up. Arthroscopy 2001; 17(1): 9-13.
  25. Hadizadeh M, Amri S, Mohafez H, Roohi SA, Mokhtar AH. Gait analysis of national athletes after anterior cruciate ligament reconstruction following three stages of rehabilitation program: Symmetrical perspective. Gait Posture 2016; 48: 152-8.
  26. Leporace G, Metsavaht L, Zeitoune G, Marinho T, oliveira T, Pereira GR, et al. Use of spatiotemporal gait parameters to determine return to sports after acl reconstruction. Acta Ortop Bras 2016; 24(2): 73-6.
  27. Jackson DW, Grood ES, Goldstein JD, Rosen MA, Kurzweil PR, Cummings JF, et al. A comparison of patellar tendon autograft and allograft used for anterior cruciate ligament reconstruction in the goat model. Am J Sports Med 1993; 21(2): 176-85.
  28. Gulotta LV, Rodeo SA. Biology of autograft and allograft healing in anterior cruciate ligament reconstruction. Clin Sports Med 2007; 26(4): 509-24.
  29. Kilcoyne KG, Dickens JF, Haniuk E, Cameron KL, Owens BD. Epidemiology of meniscal injury associated with ACL tears in young athletes. Orthopedics 2012; 35(3): 208-12.
  30. Song Y, Yang JH, Choi WR, Lee JK. Magnetic Resonance Imaging-Based Prevalence of Anterolateral Ligament Abnormalities and Associated Injuries in Knees with Acute Anterior Cruciate Ligament Injury. J Knee Surg 2018.
  31. Majewski M, Susanne H, Klaus S. Epidemiology of athletic knee injuries: A 10-year study. Knee 2006; 13(3): 184-8.
  32. Hofbauer M, Thorhauer ED, Abebe E, Bey M, Tashman S. Altered tibiofemoral kinematics in the affected knee and compensatory changes in the contralateral knee after anterior cruciate ligament reconstruction. Am J Sports Med 2014; 42(11): 2715-21.
  33. Srinivasan M. Optimal speeds for walking and running, and walking on a moving walkway. Chaos 2009; 19(2): 026112.
  34. Winter DA. Biomechanics and motor control of human movement. Hoboken, NJ: Wiley; 2009.
  35. Zeni JA Jr, Richards JG, Higginson JS. Two simple methods for determining gait events during treadmill and overground walking using kinematic data. Gait Posture 2008; 27(4): 710-4.
  36. Levangie PK, Norkin CC. Joint structure and function: a comprehensive analysis. 5th ed. Philadelphia, PA: F.A. Davis; 2011.
  37. Goradia VK, Rochat MC, Grana WA, Rohrer MD, Prasad HS. Tendon-to-bone healing of a semitendinosus tendon autograft used for ACL reconstruction in a sheep model. Am J Knee Surg 2000; 13(3): 143-51.
  38. Kim JG, Yang SJ, Lee YS, Shim JC, Ra HJ, Choi JY. The effects of hamstring harvesting on outcomes in anterior cruciate ligament-reconstructed patients: a comparative study between hamstring-harvested and -unharvested patients. Arthroscopy 2011; 27(9): 1226-34.
  39. Moghtadaei M, Nabi R, Amiri A, Mokarami F. Outcome of hamstring ligament harvest for Anterior Cruciate Ligament reconstruction with allograft versus autograft: a clinical trial. Tehran Univ Med J 2013; 71(8): 509-17. [In Persian].
  40. Shelbourne KD, Nitz P. Accelerated rehabilitation after anterior cruciate ligament reconstruction. Am J Sports Med 1990; 18(3): 292-9.
  41. Hiemstra LA, Webber S, MacDonald PB, Kriellaars DJ. Hamstring and quadriceps strength balance in normal and hamstring anterior cruciate ligament-reconstructed subjects. Clin J Sport Med 2004; 14(5): 274-80.
  42. Timoney JM, Inman WS, Quesada PM, Sharkey PF, Barrack RL, Skinner HB, et al. Return of normal gait patterns after anterior cruciate ligament reconstruction. Am J Sports Med 1993; 21(6): 887-9.
  43. Dhammi IK, Rehan UH, Kumar S. Graft choices for anterior cruciate ligament reconstruction. Indian J Orthop 2015; 49(2): 127-8.
  44. Hu J, Qu J, Xu D, Zhou J, Lu H. Allograft versus autograft for anterior cruciate ligament reconstruction: an up-to-date meta-analysis of prospective studies. Int Orthop 2013; 37(2): 311-20.
  45. Dheerendra SK, Khan WS, Singhal R, Shivarathre DG, Pydisetty R, Johnstone D. Anterior cruciate ligament graft choices: a review of current concepts. Open Orthop J 2012; 6: 281-6.
  • Receive Date: 17 November 2018
  • Revise Date: 28 April 2024
  • Accept Date: 22 May 2022