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First published on April 16, 2004, doi:10.1177/0363546503261709
This version was published on June 1, 2004
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The American Journal of Sports Medicine 32:975-983 (2004)
© 2004 American Orthopaedic Society for Sports Medicine

Abnormal Rotational Knee Motion During Running After Anterior Cruciate Ligament Reconstruction

Scott Tashman, PhD*,{dagger}, David Collon, MD{ddagger}, Kyle Anderson, MD{ddagger}, Patricia Kolowich, MD{ddagger} and William Anderst, MS{dagger}

From the {dagger} Bone and Joint Center and the {ddagger} Department of Orthopaedic Surgery, Henry Ford Health System, Detroit, Michigan

* Address correspondence and reprint requests to Scott Tashman, PhD, Bone and Joint Center, ER2015, Henry Ford Health System, Detroit, MI 48202 (e-mail: tashman{at}bjc.hfh.edu).

Background: The effectiveness of anterior cruciate ligament reconstruction for restoring normal knee kinematics is largely unknown, particularly during sports movements generating large, rapidly applied forces.

Hypothesis: Under dynamic in vivo loading, significant differences in 3-dimensional kinematics exist between anterior cruciate ligament–reconstructed knees and the contralateral, uninjured knees.

Study Design: Prospective, in vivo laboratory study.

Methods: Kinematics of anterior cruciate ligament–reconstructed and contralateral (uninjured) knees were evaluated for 6 subjects during downhill running 4 to 12 months after anterior cruciate ligament reconstruction, using a 250 frame/s stereoradiographic system. Anatomical reference axes were determined from computed tomography scans. Kinematic differences between the uninjured and reconstructed limbs were evaluated with a repeated-measures analysis of variance.

Results: Anterior tibial translation was similar for the reconstructed and uninjured limbs. However, reconstructed knees were more externally rotated on average by 3.8 ± 2.3°across all subjects and time points (P = .0011). Reconstructed knees were also more adducted, by an average of 2.8 ± 1.6°(P = .0091). Although differences were small, they were consistent in all subjects.

Conclusions: Anterior cruciate ligament reconstruction failed to restore normal rotational knee kinematics during dynamic loading.

Clinical Relevance: Although further study is required, these abnormal motions may contribute to long-term joint degeneration associated with anterior cruciate ligament injury/reconstruction.

Key Words: knee • anterior cruciate ligament (ACL) • kinematics • reconstruction • running




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