Abstract
BackgroundThe purpose of this study was to measure the tibiofemoral kinematics of anterior cruciate ligament (ACL) deficiency in a Chinese population and compare the kinematics with published data about a Caucasian population.MethodsUnilateral knees of 18 Chinese ACL-deficient (ACL-D) subjects were studied while subjects ascended stairs. Kinematic alteration was compared between ACL-D knees and contralateral ACL-intact (ACL-I) knees. The kinematic alteration of ACL deficiency was also compared between the Chinese population and published data about a Caucasian population.ResultsA statistical difference was found in the three-dimensional rotations between ACL-D and ACL-I knees. In the sagittal plane, ACL-I knees had a larger flexion angle than ACL-D knees during 40 to 50 % of the activity during stair ascent (P < 0.027) and throughout the gait cycle. A significant difference in rotational motion between ACL-D and ACL-I knees was also observed in the frontal plane during 40 to 60 % (P < 0.017) of the activity and in the transverse plane during 70 to 80 % (P < 0.028) of the activity. A greater tibial varus was demonstrated in the Chinese population while the published data revealed external tibial rotation and a statistical difference in translation in the Caucasian population.ConclusionsACL-D knees show different kinematics than ACL-I knees in the Chinese population. ACL-I knees had a larger flexion angle than ACL-D knees in the middle stage of the activity during stair ascent. A significant difference in rotational motion between ACL-D and ACL-I knees was also observed in the frontal plane during the middle phase and in the transverse plane during the terminal phase of the activity. A greater tibial varus was demonstrated in the Caucasian population while the published data revealed external tibial rotation and a statistical difference in translation in the Caucasian population.
Highlights
The purpose of this study was to measure the tibiofemoral kinematics of anterior cruciate ligament (ACL) deficiency in a Chinese population and compare the kinematics with published data about a Caucasian population
Understanding the adaptations that patients with ACL deficiency employ during stair climbing is useful for assessing the patients’ ability to manage the injury with respect to potential for joint complications and optimizing the rehabilitation protocol in order to enhance its efficacy in ACL reconstruction and total knee arthroplasty, and for treating different pathologies of the knee, such as osteoarthritis (OA) [32]
Tibiofemoral kinematics during stair ascent is investigated in patients with ACL-D knees and uninjured contralateral knees using CT, dynamic single-plane fluoroscopy, and a semi-automated matching technique
Summary
The purpose of this study was to measure the tibiofemoral kinematics of anterior cruciate ligament (ACL) deficiency in a Chinese population and compare the kinematics with published data about a Caucasian population. When attempting to stabilize their knees while stepping up, patients with anterior cruciate ligament (ACL) injury exhibit altered tibiofemoral kinematics, knee joint moment, muscle co-activation, shear forces, and ACL strain [13]. Gao et al investigated the three-dimensional (3D) joint kinematics of ACL-D and ACL-reconstructed knees during stair ascent and descent and found that the ACL-D knees exhibited significant extension [11] They did not investigate ACL-D knees in subjects with concomitant injuries, such as meniscus injuries, collateral ligament injuries, and cartilage degeneration. These studies have greatly improved our knowledge of knee kinematics during step-up activities, the different experimental designs and coordinate system selections make it difficult to obtain a systematic understanding of the knee joint kinematics during step-up activities
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