Bilateral waveform analysis of gait biomechanics presurgery to 12 months following ACL reconstruction compared to controls
2025

Gait Biomechanics After ACL Reconstruction

Sample size: 58 publication 10 minutes Evidence: high

Author Information

Author(s): Büttner Christin, Lisee Caroline, Bjornsen Elizabeth, Buck Ashley, Favoreto Natália, Creighton Alexander, Kamath Ganesh, Spang Jeffrey, Franz Jason R., Blackburn Troy, Pietrosimone Brian

Primary Institution: University of North Carolina Chapel Hill

Hypothesis

Gait biomechanics of the ACLR and uninvolved limbs would become more symmetrical over time, however, both limbs would demonstrate less dynamic and more sustained waveforms compared with controls at all timepoints.

Conclusion

Individuals with ACLR demonstrate less dynamic gait biomechanics bilaterally from the preop timepoint up to 12 months post-ACLR, which may contribute to knee joint tissue breakdown.

Supporting Evidence

  • ACLR limb demonstrated lesser vertical ground reaction force during early stance compared to uninvolved limb.
  • ACLR limb exhibited lesser knee extension moment at all timepoints compared to uninvolved limb.
  • ACLR limb showed greater knee flexion angle during mid- to late stance compared to uninvolved limb.
  • Uninvolved limb demonstrated lesser knee flexion angle during early to mid-stance at all timepoints compared to controls.
  • Both ACLR and uninvolved limbs showed persistent aberrant gait biomechanics compared to controls.
  • Gait biomechanics became more symmetrical over the first 12 months post-ACLR.
  • Less dynamic waveforms were linked to worse knee joint health outcomes.

Takeaway

After knee surgery, people walk differently for a long time, which can hurt their knees more. It's important to help them walk better with exercises.

Methodology

A prospective, longitudinal cohort study with nested case-control comparisons of gait biomechanics in individuals with primary unilateral ACL injury and matched controls.

Potential Biases

Potential biases due to the exclusion of individuals with certain knee conditions or those who received different types of surgical interventions.

Limitations

Results may not be generalizable to individuals with different graft types or those outside the age range of 16 to 35 years.

Participant Demographics

Individuals aged 16 to 35 years with primary unilateral ACL injury; matched controls with no history of knee injury.

Statistical Information

P-Value

p<0.001

Statistical Significance

p<0.001

Digital Object Identifier (DOI)

10.1002/jor.26001

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