Journal
AMERICAN JOURNAL OF SPORTS MEDICINE
Volume 32, Issue 5, Pages 1250-1255Publisher
AMER ORTHOPAEDIC SOC SPORT MED
DOI: 10.1177/0363546503262173
Keywords
anterior cruciate ligament (ACL); knee kinematics; functional stability; biomechanics; compensators
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Background: Some patients with anterior cruciate ligament deficiency can function well and participate in high-level sports, whereas others have functional limitations even during activities of daily living. Hypothesis: Patients who function well after an anterior cruciate ligament injury can stabilize the knee joint during gait by an anterior positioning of the tibia. Study Design: Controlled laboratory study. Methods: Sagittal tibial translation was registered with the CA-4000 electrogoniometer, during the Lachman test and walking, in 20 patients with a unilateral anterior cruciate ligament injury. Eleven patients functioned well (Lysholm score greater than or equal to84), and 9 patients had poor knee function (Lysholm score <84). Results: During gait, the well-functioning group had 24% greater anterior translation in the injured leg compared to the noninjured leg. In the poor-functioning group, the anterior translation in the injured leg was 16% smaller compared to the noninjured leg (P = .0003). Tibial translation during the Lachman test was similar in the injured leg in the 2 groups. Conclusion: Patients who function well position their tibiae near the anterior border of the joint play. This position may encourage functional stability. Clinical Relevance: Rehabilitation that emphasizes training to stabilize the tibia in an anterior position may improve functional stability of the anterior cruciate ligament-deficient knee.
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