Gait adaptations following multiple-ligament knee reconstruction occur with altered knee kinematics during level walking.
PURPOSE
The biomechanical behaviour of the knee following multiple-ligament reconstruction (MLKR) may play a role in the pathogenesis of post-traumatic osteoarthritis. The aim of this study was to compare three-dimensional knee kinematics and gait characteristics of MLKR patients to healthy controls during level walking.


METHODS
Three-dimensional optoelectronic motion capture during overground walking was performed on 16 patients with MLKR and a group of healthy controls matched individually to each patient for age, gender, height and weight. Three-dimensional knee angles were extracted from the weight acceptance and propulsion sub-phases of gait. Statistical analysis was performed using group-aggregated data, as well as for each patient-control pair using a single-case approach.


RESULTS
Although group analysis detected few differences, single-case analysis revealed significant differences for a proportion of patients for all dependent variables during weight acceptance and propulsion sub-phases of stance. These kinematic differences occurred in the context of reduced gait velocity, step length and cadence, as well as increased time spent in double support.


CONCLUSION
Patients with MLKR display abnormalities in knee kinematics during gait at an average of 4.5 years after surgery. The pattern of kinematic abnormalities appears individual specific and may not be related to differences in spatiotemporal gait characteristics. The current findings describe detailed functional outcomes of MLKR reconstruction at average medium-term follow-up that provide improved prognostic information for clinicians to counsel patients with these types of injuries.
['Scholes|Corey J|CJ|', 'Lynch|Joe T|JT|', 'Ebrahimi|Milad|M|', 'Fritsch|Brett A|BA|', 'Parker|David A|DA|']
D000222:Adaptation, Physiological D000328:Adult D001696:Biomechanical Phenomena D005260:Female D005684:Gait D006801:Humans D021621:Imaging, Three-Dimensional D007717:Knee D007718:Knee Injuries D007719:Knee Joint D008023:Ligaments, Articular D008297:Male D009048:Motor Skills D016059:Range of Motion, Articular D019651:Reconstructive Surgical Procedures D012189:Retrospective Studies D013647:Task Performance and Analysis D016138:Walking
Gait Knee Multiple-ligament reconstruction Single-case Variability Stance