Abstract
The objective of the study was to evaluate the clinical, functional, and biomechanical symptoms in patients with anterior cruciate ligament (ACL) rupture before and after ACL reconstruction. The study enrolled 20 patients and 20 healthy subjects as controls. Walking biomechanics was assessed at three time points: before surgery and three months and a year or more after surgical reconstruction. Impact loads on both sides differed significantly from the respective values before surgery (p<0.05). Walking cycle duration decreased with time after surgery. On both sides (affected and unaffected), hip movement amplitudes were significantly smaller than in control (p<0.05). They remained so in the follow-up periods after the reconstruction. Before ACL reconstruction, the amplitude of the main flexion of the knee was significantly reduced both on the affected and unaffected sides. The amplitude gradually increased after the reconstruction, and a year post-surgery, it reached, on the operated side, the same values as in the control group. Complete functional recovery of the knee joint was not achieved within a year after the ACL surgical reconstruction. The remaining changes, however, were not clinically pronounced and could only be detected by instrumental gait analysis. The compensatory processes developed bilaterally, in both the hip and knee joints.
Highlights
A considerable amount of literature has been published on the effects of anterior cruciate ligament (ACL) rupture on gait biomechanics
The decreased hip flexion-extension amplitude before the reconstruction led to a change in the stride length and, indirectly, to a shorter walking cycle duration (WC)
Complete functional recovery of the knee joint was not achieved within a year after ACL surgical reconstruction
Summary
A considerable amount of literature has been published on the effects of anterior cruciate ligament (ACL) rupture on gait biomechanics. The authors describe different functional dynamics over time after surgery [1,2,3]. Goetschius et al observed decreased amplitudes of knee flexion–extension–adduction and hip adduction in the affected limb 1.5 years after ACL reconstruction. At later periods (within 3.5 years), the authors found no differences from the contralateral limb, Appl. Sci. 2020, 10, 3378 they noted decreased amplitudes of knee flexion and knee and hip adduction 8.5 years after the ACL reconstruction [4]. The study showed a gradual functional improvement in the postoperative period—a significant increase in mean walking speed and in the movement amplitudes of both hips and knees, as well as improved range of ankle motion in the operated limb [5]
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