Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2015
Does meniscal pathology alter gait knee biomechanics and strength post-ACL reconstruction?
СтатьяНазвание и аннотация: Перевод в очереди
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Hall Michelle, Bryant Adam L, Wrigley Tim V, Pratt Clare, Crossley Kay M, Whitehead Tim S, Morris Hayden G, Clark Ross A, Perraton Luke G
Аннотация
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.
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.