Background: It is possible that gait abnormalities may play a role in
the pathogenesis of meniscal or chondral injury as well as
osteoarthritis of the knee in patients with anterior cruciate ligament
deficiency.
Hypothesis: The three-dimensional kinematics of anterior cruciate
ligament-deficient knees are changed even during low-stress activities,
such as walking, but can be restored by reconstruction.
Study Design: Case control study.
Methods: Using a three-dimensional optoelectronic gait analysis system,
we examined 13 patients with anterior cruciate ligament-deficient knees,
21 patients with anterior cruciate ligament-reconstructed knees, and 10
control subjects with uninjured knees during walking.
Results: Normal patterns of knee flexion-extension, abduction-adduction,
and internal-external rotation during the gait cycle were maintained by
all subjects. A significant difference in tibial rotation angle during
the initial swing phase was found in anterior cruciate
ligament-deficient knees compared with reconstructed and control knees.
The patients with anterior cruciate ligament-deficient knees rotated the
tibia internally during the initial swing phase, whereas the others
rotated externally.
Conclusions: Patients with anterior cruciate ligament-deficient knees
experienced repeated episodes of rotational instability during walking,
whereas patients with reconstruction experienced tibial rotation that is
closer to normal.
Clinical Relevance: Repeated episodes of knee rotational instability may
play a role in the development of pathologic knee conditions. (C) 2003
American Orthopaedic Society for Sports Medicine