Does meniscal pathology alter gait knee biomechanics and strength post-ACL reconstruction?

• Published in: Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA Vol. 24; no. 5; pp. 1501 - 1509
• Main Authors: Hall, Michelle, Bryant, Adam L., Wrigley, Tim V., Pratt, Clare, Crossley, Kay M., Whitehead, Tim S., Morris, Hayden G., Clark, Ross A., Perraton, Luke G.
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.05.2016; Springer Nature B.V
• Subjects: Adult; Anterior Cruciate Ligament - surgery; Anterior Cruciate Ligament Injuries - complications; Anterior Cruciate Ligament Injuries - physiopathology; Anterior Cruciate Ligament Injuries - surgery; Anterior Cruciate Ligament Reconstruction - rehabilitation; Arthritis; Biomechanical Phenomena; Biomechanics; Cartilage; Female; Gait; Gait - physiology; Humans; Investigations; Kinematics; Knee; Knee Injuries - physiopathology; Knee Injuries - surgery; Knee Joint - physiopathology; Knee Joint - surgery; Ligaments; Male; Medicine; Medicine & Public Health; Menisci, Tibial - pathology; Muscle strength; Muscle Strength - physiology; Orthopedics; Osteoarthritis; Osteoarthritis, Knee - etiology; Osteoarthritis, Knee - physiopathology; Osteoarthritis, Knee - surgery; Pathology; Surgery; Tibial Meniscus Injuries - complications; Tibial Meniscus Injuries - physiopathology; Tibial Meniscus Injuries - surgery; Trauma; Young Adult; Australia; Anterior cruciate ligament reconstruction; Meniscus; Knee moments; Strength
• ISSN: 0942-2056; 1433-7347
• DOI: 10.1007/s00167-015-3908-x

Purpose Individuals following anterior cruciate ligament reconstruction (ACLR) with concomitant meniscal pathology have a higher risk of developing knee osteoarthritis (OA) compared to those with isolated ACLR. Knee extensor weakness and altered dynamic knee joint biomechanics have been suggested to play a role in the development of knee OA following ACLR. This study investigated whether these factors differ in people following ACLR who have concomitant meniscal pathology compared to patients with isolated ACLR. Methods Thirty-three patients with isolated ACLR and 34 patients with ACLR and meniscal pathology underwent strength and gait assessment 12–24 months post-operatively. Primary measures were peak isometric knee extensor torque and knee adduction moment (peak and impulse). Secondary measures included peak knee flexion moment and knee kinematics (sagittal and transverse). Results There were no between-group differences in knee extensor strength [mean difference (95 % CI) 0.09 (−0.23 to 0.42) Nm/kg, n.s.], peak knee adduction moment [−0.02 (−0.54 to 0.49) Nm/(BW × HT) %, n.s.] or knee adduction moment impulse [0.01 (−0.15 to 0.17) Nm/(BW × HT) %, p  = n.s.]. No between-group differences were found for any secondary measures. Conclusions No evidence was found to suggest that the higher prevalence of OA in patients with ACLR and meniscal pathology compared to patients with isolated ACLR is attributed to reduced knee muscle strength or altered knee joint biomechanics assessed 1–2 years post-surgery. Given that there is a higher incidence of knee OA in patients with concomitant meniscal pathology and ACLR, further investigation is needed so that population-specific rehabilitation protocols can be developed. Level of evidence III.