Whether Patients with Anterior Cruciate Ligament Reconstruction Walking at a Fast Speed Show more Kinematic Asymmetries?
Objective Knee kinematic asymmetries after anterior cruciate ligament reconstruction (ACLR) are correlated with poor clinical outcomes, such as the progression of knee cartilage degenerations or reinjuries. Fast walking in patients with knee conditions may exacerbate knee kinematic asymmetries, but...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wiley
2024-04-01
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| Series: | Orthopaedic Surgery |
| Subjects: | |
| Online Access: | https://doi.org/10.1111/os.14017 |
| _version_ | 1797231067225128960 |
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| author | Huahao Lai Xiaoling Chen Wenhan Huang Zhenyan Xie Yuan Yan Ming Kang Yu Zhang Jiehua Huang Xiaolong Zeng |
| author_facet | Huahao Lai Xiaoling Chen Wenhan Huang Zhenyan Xie Yuan Yan Ming Kang Yu Zhang Jiehua Huang Xiaolong Zeng |
| author_sort | Huahao Lai |
| collection | DOAJ |
| description | Objective Knee kinematic asymmetries after anterior cruciate ligament reconstruction (ACLR) are correlated with poor clinical outcomes, such as the progression of knee cartilage degenerations or reinjuries. Fast walking in patients with knee conditions may exacerbate knee kinematic asymmetries, but its impact on ACLR patients is uncertain. The aim of this study is to investigate if fast walking induces more knee kinematic asymmetries in unilateral ACLR patients. Methods This cross‐sectional study enrolled 55 patients with unilateral ACLR from January 2020 to July 2022. There were 48 males and seven females with an average age of 30.6 ± 6.4 years. Knee kinematic data were collected at three walking speeds: self‐selected, fast (150% normal), and slow (50% normal). A 3D knee kinematic analysis system measured the data, and self‐reported outcomes assessed comfort levels during walking. We used SPM1D for two‐way repeated ANOVA and posthoc paired t‐tests to analyze kinematic differences in groups. Results In fast walking, ACLR knees exhibited more transverse kinematic asymmetries than intact knees, including greater external rotation angle (1.8°, 38%–43%; gait cycle [GC], p < 0.05 & 1.8–2.7°, 50%–61% GC, p < 0.05) and increased proximal tibial translation (2.1–2.5 mm, 2%–6% GC, p < 0.05 & 2.5–3.2 mm, 92%–96% GC, p < 0.05). Additionally, ACLR knees showed greater posterior tibial translation than intact knees (3.6–3.7 mm, 7%–8% GC, p < 0.05) during fast walking. No posterior tibial translation asymmetries were observed in slow walking compared to normal walking levels. ACLR knees have the most comfortable feelings in slow walking speed, and the most uncomfortable feelings in fast walking speed levels (29%). Conclusions Fast walking induces additional external tibial rotation and proximal and posterior tibial translation asymmetries in ACLR patients. This raises concerns about long‐term safety and health during fast walking. Fast walking, not self‐selected speed, is beneficial for identifying postoperative gait asymmetries in ACLR patients. |
| first_indexed | 2024-04-24T15:38:29Z |
| format | Article |
| id | doaj.art-1142b14466a344e1b7481784b68af1d8 |
| institution | Directory Open Access Journal |
| issn | 1757-7853 1757-7861 |
| language | English |
| last_indexed | 2024-04-24T15:38:29Z |
| publishDate | 2024-04-01 |
| publisher | Wiley |
| record_format | Article |
| series | Orthopaedic Surgery |
| spelling | doaj.art-1142b14466a344e1b7481784b68af1d82024-04-02T01:03:25ZengWileyOrthopaedic Surgery1757-78531757-78612024-04-0116486487210.1111/os.14017Whether Patients with Anterior Cruciate Ligament Reconstruction Walking at a Fast Speed Show more Kinematic Asymmetries?Huahao Lai0Xiaoling Chen1Wenhan Huang2Zhenyan Xie3Yuan Yan4Ming Kang5Yu Zhang6Jiehua Huang7Xiaolong Zeng8Department of Bone Oncology Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University Guangzhou ChinaDepartment of Rehabilitation Medicine Huizhou Central People's Hospital Huizhou ChinaDepartment of Bone Oncology Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University Guangzhou ChinaDepartment of Bone Oncology Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University Guangzhou ChinaDepartment of Orthopaedic Surgery Huizhou Central People's Hospital Huizhou ChinaDepartment of Orthopaedic Surgery Huizhou Central People's Hospital Huizhou ChinaDepartment of Bone Oncology Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University Guangzhou ChinaDepartment of Orthopaedic Surgery Huizhou Central People's Hospital Huizhou ChinaDepartment of Orthopaedics Guangdong Provincial Hospital of Chinese Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine Guangzhou ChinaObjective Knee kinematic asymmetries after anterior cruciate ligament reconstruction (ACLR) are correlated with poor clinical outcomes, such as the progression of knee cartilage degenerations or reinjuries. Fast walking in patients with knee conditions may exacerbate knee kinematic asymmetries, but its impact on ACLR patients is uncertain. The aim of this study is to investigate if fast walking induces more knee kinematic asymmetries in unilateral ACLR patients. Methods This cross‐sectional study enrolled 55 patients with unilateral ACLR from January 2020 to July 2022. There were 48 males and seven females with an average age of 30.6 ± 6.4 years. Knee kinematic data were collected at three walking speeds: self‐selected, fast (150% normal), and slow (50% normal). A 3D knee kinematic analysis system measured the data, and self‐reported outcomes assessed comfort levels during walking. We used SPM1D for two‐way repeated ANOVA and posthoc paired t‐tests to analyze kinematic differences in groups. Results In fast walking, ACLR knees exhibited more transverse kinematic asymmetries than intact knees, including greater external rotation angle (1.8°, 38%–43%; gait cycle [GC], p < 0.05 & 1.8–2.7°, 50%–61% GC, p < 0.05) and increased proximal tibial translation (2.1–2.5 mm, 2%–6% GC, p < 0.05 & 2.5–3.2 mm, 92%–96% GC, p < 0.05). Additionally, ACLR knees showed greater posterior tibial translation than intact knees (3.6–3.7 mm, 7%–8% GC, p < 0.05) during fast walking. No posterior tibial translation asymmetries were observed in slow walking compared to normal walking levels. ACLR knees have the most comfortable feelings in slow walking speed, and the most uncomfortable feelings in fast walking speed levels (29%). Conclusions Fast walking induces additional external tibial rotation and proximal and posterior tibial translation asymmetries in ACLR patients. This raises concerns about long‐term safety and health during fast walking. Fast walking, not self‐selected speed, is beneficial for identifying postoperative gait asymmetries in ACLR patients.https://doi.org/10.1111/os.14017ACLRGaitKinematic AsymmetriesWalking Speed |
| spellingShingle | Huahao Lai Xiaoling Chen Wenhan Huang Zhenyan Xie Yuan Yan Ming Kang Yu Zhang Jiehua Huang Xiaolong Zeng Whether Patients with Anterior Cruciate Ligament Reconstruction Walking at a Fast Speed Show more Kinematic Asymmetries? Orthopaedic Surgery ACLR Gait Kinematic Asymmetries Walking Speed |
| title | Whether Patients with Anterior Cruciate Ligament Reconstruction Walking at a Fast Speed Show more Kinematic Asymmetries? |
| title_full | Whether Patients with Anterior Cruciate Ligament Reconstruction Walking at a Fast Speed Show more Kinematic Asymmetries? |
| title_fullStr | Whether Patients with Anterior Cruciate Ligament Reconstruction Walking at a Fast Speed Show more Kinematic Asymmetries? |
| title_full_unstemmed | Whether Patients with Anterior Cruciate Ligament Reconstruction Walking at a Fast Speed Show more Kinematic Asymmetries? |
| title_short | Whether Patients with Anterior Cruciate Ligament Reconstruction Walking at a Fast Speed Show more Kinematic Asymmetries? |
| title_sort | whether patients with anterior cruciate ligament reconstruction walking at a fast speed show more kinematic asymmetries |
| topic | ACLR Gait Kinematic Asymmetries Walking Speed |
| url | https://doi.org/10.1111/os.14017 |
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