Tibiofemoral Joint Kinematics of the Anterior Cruciate Ligament-Reconstructed Knee During a Single-Legged Hop Landing

Abstract

Background: Abnormal 3-dimensional tibiofemoral joint kinematics have been identified in anterior cruciate ligament-reconstructed knees during functional gait tasks, which is suggested to directly affect risk of knee osteoarthritis. However, the extent to which similar high-risk abnormalities are present during more demanding maneuvers, such as single-legged hopping, is largely unknown. Hypothesis: When performing a single-legged forward hop landing, the reconstructed knee will demonstrate altered sagittal, frontal, and transverse plane kinematics compared with the contralateral limb. Study Design: Controlled laboratory study. Methods: High-speed biplane radiography was used to quantify bilateral 3-dimensional tibiofemoral joint kinematics in 9 subjects with unilaterally reconstructed anterior cruciate ligaments (mean time after surgery, 4 months) during 3 single-legged, forward hop landing trials. Mean subject-based initial foot contact and maximum stance (0-250 ms) values were calculated for each kinematic variable. Two-tailed paired t tests were subsequently applied to examine for the main effect of limb (reconstructed vs contralateral). Results: The reconstructed knees exhibited significantly greater extension ( P = .04), external tibial rotation ( P = .006), and medial tibial translation ( P = .02) than the contralateral knees at initial contact. Reconstructed knees underwent significantly greater maximum flexion ( P = .05), maximum external tibial rotation ( P = .01), and maximum anterior tibial translation ( P = .02). No significant differences existed between limbs for initial contact ( P = .65) or maximum adduction-abduction ( P = .55). Conclusion: Tibiofemoral joint kinematics of the anterior cruciate ligament-reconstructed knee are significantly different from those of the uninjured contralateral limb during a single-legged hop landing. This altered kinematic profile, in conjunction with the large impact loads associated with hopping, may further contribute to the risk of posttraumatic knee osteoarthritis. Clinical Relevance: Returning to sports involving dynamic single-legged landings at 4 months after anterior cruciate ligament reconstruction surgery may contribute to accelerated knee joint degeneration.