Knee kinematics and joint moments during gait following anterior cruciate ligament reconstruction: a systematic review and meta-analysis

BackgroundAbnormal gait after anterior cruciate ligament reconstruction (ACLR) may contribute to development and/or progression of knee osteoarthritis.ObjectiveTo conduct a systematic review and meta-analysis of knee kinematics and joint moments during walking after ACLR.MethodsWe searched seven ele...

Full description

Saved in:
Bibliographic Details
Published in:British journal of sports medicine 2016-05, Vol.50 (10), p.597-612
Main Authors: Hart, Harvi F, Culvenor, Adam G, Collins, Natalie J, Ackland, David C, Cowan, Sallie M, Machotka, Zuzana, Crossley, Kay M
Format: Article
Language:English
Subjects:
Anterior Cruciate Ligament Injuries - physiopathology
Anterior Cruciate Ligament Injuries - surgery
Anterior Cruciate Ligament Reconstruction
Biomechanical Phenomena - physiology
Biomechanics
Gait
Gait - physiology
Humans
Kinematics
Knee
Knee Joint - physiology
Ligaments
Meta-analysis
Postoperative Period
Systematic review
Walking
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:BackgroundAbnormal gait after anterior cruciate ligament reconstruction (ACLR) may contribute to development and/or progression of knee osteoarthritis.ObjectiveTo conduct a systematic review and meta-analysis of knee kinematics and joint moments during walking after ACLR.MethodsWe searched seven electronic databases and reference lists of relevant papers, for cross-sectional, human-based observational studies comparing knee joint kinematics and moments during level walking in individuals with ACLR, with the uninjured contralateral knee or healthy individuals as a control. Two independent reviewers appraised methodological quality (modified Downs and Black scale). Where possible, data were pooled by time post-ACLR (RevMan), otherwise narrative synthesis was undertaken.ResultsThirty-four studies were included. Meta-analysis revealed significant sagittal plane deficits in ACLR knees. We found greater knee flexion angles (standardised mean difference: 1.06; 95% CI 0.39 to 1.74) and joint moments (1.61; 0.87 to 2.35) 3 years after ACLR (vs healthy controls) (0.09; −0.63 to 0.81). No transverse plane conclusions could be drawn.ConclusionsSagittal plane biomechanics, rather than the knee adduction moment, appear to be more relevant post-ACLR. Better understanding of sagittal plane biomechanics is necessary for optimal post-operative recovery, and to potentially prevent early onset and progression of knee OA after ACLR.Trial registration numberPROSPERO systematic review protocol registration number CRD4201400882 2.
ISSN:0306-3674
1473-0480
DOI:10.1136/bjsports-2015-094797