The knee adduction moment in hamstring and patellar tendon anterior cruciate ligament reconstructed knees

Abstract

The external knee adduction moment during gait has previously been associated with knee osteoarthritis, and although it has been shown to be greater following anterior cruciate ligament (ACL) reconstruction surgery compared to a control group, it has not been compared between different graft types. Given that the incidence of radiographic knee osteoarthritis appears to be greater following patellar tendon compared to hamstring tendon ACL reconstruction, this study tested the hypothesis that the knee adduction moment would also be increased following patellar tendon ACL reconstruction. In 48 male participants (16 patellar tendon graft, 16 hamstring graft and 16 controls), the external knee adduction moment was measured during level walking in a gait laboratory at mean of 10months after surgery. There was no difference in the knee adduction moment between the hamstring and patellar tendon groups, and both patient groups had a significantly reduced knee adduction moment compared to the control group. In the hamstring group, the smaller adduction moment was associated with the patients walking with less knee varus whereas in the patellar tendon group, the smaller moment was associated with the patients walking with a decreased vertical ground reaction force. These results indicate that in male patients during the early stages of recovery from ACL reconstruction, the knee adduction moment is not greater than controls for either hamstring or patellar tendon graft types. Although the knee adduction moment was similar between the two graft types, the overall magnitude of the moment was influenced by different biomechanical factors. III.