Gender differences in knee kinematics during weight-bearing knee flexion for patients with arthrofibrosis after anterior cruciate ligament reconstruction

Ling Zhang,Jiling Ye,Bin Cai,Xin Jiang,Shuai Fan

doi:10.1186/s13018-021-02729-3

Abstract

BackgroundKnowledge of tibiofemoral and patellofemoral joint kinematics is important for understanding gender-related dimorphism in developing knee arthrofibrosis and advancement of related treatments. The objective of our study was to investigate gender differences existing in tibiofemoral kinematics and patellar tracking in patients with arthrofibrosis after anterior cruciate ligament (ACL) reconstruction during weight-bearing knee flexion.MethodsThe tibiofemoral and patellofemoral joint kinematics were measured in 30 patients (15 male and 15 female) with arthrofibrosis after ACL reconstruction during a lunge task, using computed tomography and dual fluoroscopic imaging system. These data were analyzed for gender differences.ResultsThe range of tibial rotation, patellar inferior shift, tilt, and flexion were significantly decreased in the affected knee compared to the contralateral knee from 15° to 75° of knee flexion (P ≤ 0.04). Statistically significant difference was detected for medial tibial translation between male and female patients at 60° (P = 0.04) and 75° of knee flexion (P = 0.02). The tibial rotation was significantly decreased at 60° (P = 0.03) and 75° of knee flexion (P < 0.01) in females. The inferior patellar shift in females was significantly lower than that in males at 15° (P = 0.04) and 30° of knee flexion (P = 0.01). The patellar tilt was significantly lower at 60° (P = 0.02) and 75° of knee flexion (P < 0.01) in females compared to males.ConclusionsThe results indicated a significant effect of gender on knee kinematics in patients with arthrofibrosis after ACL reconstruction during weight-bearing knee flexion. These gender differences in tibiofemoral kinematics and patellar tracking may warrant further investigations to determine implications for making gender-specific surgical treatments and rehabilitation programs.

Highlights

Knowledge of tibiofemoral and patellofemoral joint kinematics is important for understanding genderrelated dimorphism in developing knee arthrofibrosis and advancement of related treatments
We investigated tibiofemoral kinematics and patellar tracking in patients with arthrofibrosis after anterior cruciate ligament (ACL) reconstruction
Mayr et al [3] reported that long-term range of motion (ROM) improvement can be achieved by arthroscopic arthrolysis; patients complain of persistent symptoms, including decreased patellar mobility, anterior knee pain, and quadriceps weakness even after the intervention

Summary

Introduction

Knowledge of tibiofemoral and patellofemoral joint kinematics is important for understanding genderrelated dimorphism in developing knee arthrofibrosis and advancement of related treatments. The objective of our study was to investigate gender differences existing in tibiofemoral kinematics and patellar tracking in patients with arthrofibrosis after anterior cruciate ligament (ACL) reconstruction during weight-bearing knee flexion. Arthrofibrosis impairs gait and athleticism, and it has been suggested to increase the risk of developing knee osteoarthritis (OA) in the long term [3, 4]. With arthrofibrosis after ACL reconstruction, female patients generally report worse outcomes scores than males on the self-reported knee function [3]. Females are at a higher risk of developing knee OA in the long term, and it was suggested that the cartilage of females may be more vulnerable than that of males [3]

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