Gait Biomechanics six months post ACL Reconstruction
Research type
Research Study
Full title
Biomechanics of both legs six months following unilateral ACL reconstruction: Are there treatable deficits and is there a link to fear behaviour?
IRAS ID
139234
Contact name
Justine Bee
Contact email
Sponsor organisation
Robert Jones & Agnes Hunt Orthopaedic Hospital NHS Foundation Trust
Research summary
Anterior Cruciate Ligament (ACL) disruption is a common knee injury which typically occurs in young, active individuals. A significant proportion of these patients choose to have their ligament reconstructed. It is well recognised that patients who have suffered ACL injury are at risk of future development of knee osteoarthritis (OA), and this risk is still present even if the ACL has been reconstructed. The causes and factors which make OA more or less likely after ACL injury are widely debated in the literature. Important factors for these individuals are abnormal joint loading and over contracting antagonist muscles, as these factors are modifiable with focused training and rehabilitation. Loading of the knee is significantly increased by simultaneous contraction (co-contraction) of the quadriceps, hamstrings and gastro-soleus as the muscle forces around the knee can make an equal, if not greater, contribution to joint loading than the action of body weight alone.
Previous studies have looked at patients with knee OA, finding that patients with unilateral knee osteoarthritis have bilaterally abnormal biomechanics, and that these abnormalities frequently persisted despite treatment of the affected joint.
Excessive co-contraction has been identified at the affected knee in ACLR and ACLD patients and this has been related to clinical outcome. It is not known why this muscle activity is abnormal on the affected knee or what the mechanical effect is on the ‘normal’ side. An understanding of these elements could enable the development of new treatments and rehabilitation techniques aimed at improving outcomes and preventing arthritis development in this active population.
The purpose of this study is to determine whether gait patterns and muscular co-contraction are abnormal bilaterally in ACL reconstructed patients and whether these abnormalities are correlated with patient reported measures of kinesiophobia (fear of movement related pain) pain or subjective instability.
REC name
Yorkshire & The Humber - South Yorkshire Research Ethics Committee
REC reference
13/YH/0357
Date of REC Opinion
24 Oct 2013
REC opinion
Further Information Favourable Opinion