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Detecting side-to-side differences of lower limb biomechanics during single-legged forward landing after anterior cruciate ligament reconstruction

  • Makoto Asaeda
    Correspondence
    Corresponding author. Faculty of Wakayama Health Care Sciences, Takarazuka University of Medical and Health Care, 2252, Nakanoshima, Wakayama, 640-8392, Japan. Fax: +81 73 424-8544.
    Affiliations
    Sports Medical Center, Hiroshima University Hospital, 1-2-3, Kasumi, Minami-ku, Hiroshima, 734-8551, Japan

    Faculty of Wakayama Health Care Sciences, Takarazuka University of Medical and Health Care, 2252, Nakanoshima, Wakayama, 640-8392, Japan
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  • Atsuo Nakamae
    Affiliations
    Department of Orthopaedic Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3, Kasumi, Minami-ku, Hiroshima, 734-8551, Japan
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  • Yukio Mikami
    Affiliations
    Department of Rehabilitation Medicine, Hiroshima University Hospital, 1-2-3, Kasumi, Minami-ku, Hiroshima, 734-8551, Japan
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  • Kazuhiko Hirata
    Affiliations
    Sports Medical Center, Hiroshima University Hospital, 1-2-3, Kasumi, Minami-ku, Hiroshima, 734-8551, Japan

    Division of Rehabilitation, Department of Clinical Practice and Support, Hiroshima University Hospital, 1-2-3, Kasumi, Minami-ku, Hiroshima, 734-8551, Japan
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  • Yoshifumi Kono
    Affiliations
    Division of Rehabilitation, Department of Clinical Practice and Support, Hiroshima University Hospital, 1-2-3, Kasumi, Minami-ku, Hiroshima, 734-8551, Japan
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  • Takumi Abe
    Affiliations
    Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3, Kasumi, Minami-ku, Hiroshima, 734-8551, Japan
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  • Masataka Deie
    Affiliations
    Department of Orthopaedic Surgery, Hiroshima City Hospital, 7-33 Motomachi, Naka-ku, Hiroshima, 730-8518, Japan
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  • Nobuo Adachi
    Affiliations
    Sports Medical Center, Hiroshima University Hospital, 1-2-3, Kasumi, Minami-ku, Hiroshima, 734-8551, Japan

    Department of Orthopaedic Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3, Kasumi, Minami-ku, Hiroshima, 734-8551, Japan
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Published:September 24, 2022DOI:https://doi.org/10.1016/j.jos.2022.09.002

      Abstract

      Background

      Motion analysis can be used to evaluate functional recovery after anterior cruciate ligament (ACL) reconstruction; however, the biomechanics parameters of the lower limb that are specifically altered in ACL-reconstructed knees compared to the contralateral side are not well understood. This retrospective study aimed to compare side-to-side differences in lower limb biomechanics during the first 100 milliseconds (ms) after initial contact in a single-leg forward landing task.

      Methods

      Using three-dimensional motion analysis, lower joint kinematic and kinetic variables were measured 8–10 months postoperatively in 22 patients who had undergone ACL reconstruction. We determined side-to-side differences in lower limb biomechanics over the 100-ms timeframe after landing, and receiver operating characteristic (ROC) curve analyses were performed to calculate the area under the curve (AUC) for parameters showing significant side-to-side differences.

      Results

      During the 100-ms timeframe after landing, 58 kinematic and kinetic items showed significant side-to-side differences. Side-to-side differences in lower limb biomechanics over the 40-ms timeframe after landing existed. The ROC curve analysis identified 11 items with AUC values ≥ 0.70, including hip flexion, abduction moment, and knee joint power, and their AUC values were not significantly different.

      Conclusion

      Hip flexion/abduction moment and knee power after GRF max could be used as outcomes for assessing functional recovery in patients who have undergone ACL reconstruction.

      Keywords

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      References

        • Li X.
        • Xu C.P.
        • Song J.Q.
        • Jiang N.
        • Yu B.
        Single-bundle versus double-bundle anterior cruciate ligament reconstruction: an up-to-date meta-analysis.
        Int Orthop. 2013 Feb; 37: 213-226
        • Xu M.
        • Gao S.
        • Zeng C.
        • Han R.
        • Sun J.
        • Li H.
        • et al.
        Outcomes of anterior cruciate ligament reconstruction using single-bundle versus double-bundle technique: meta-analysis of 19 randomized controlled trials.
        Arthroscopy. 2013 Feb; 29: 357-365
        • Grindem H.
        • Snyder-Mackler L.
        • Moksnes H.
        • Engebretsen L.
        • Risberg M.A.
        Simple decision rules can reduce reinjury risk by 84% after ACL reconstruction: the Delaware-Oslo ACL cohort study.
        Br J Sports Med. 2016 Jul; 50: 804-808
        • Kotsifaki A.
        • Whiteley R.
        • Van Rossom S.
        • Korakakis V.
        • Bahr R.
        • Sideris V.
        • et al.
        Single leg hop for distance symmetry masks lower limb biomechanics: time to discuss hop distance as decision criterion for return to sport after ACL reconstruction?.
        Br J Sports Med. 2022 Mar; 56: 249-256
        • Wren T.A.L.
        • Mueske N.M.
        • Brophy C.H.
        • Pace J.L.
        • Katzel M.J.
        • Edison B.R.
        • et al.
        Hop distance symmetry does not indicate normal landing biomechanics in adolescent athletes with recent anterior cruciate ligament reconstruction.
        J Orthop Sports Phys Ther. 2018 Aug; 48: 622-629
        • Hughes G.
        • Musco P.
        • Caine S.
        • Howe L.
        Lower limb asymmetry after anterior cruciate ligament reconstruction in adolescent athletes: a systematic review and meta-analysis.
        J Athl Train. 2020 Aug 1; 55: 811-825
        • King E.
        • Richter C.
        • Daniels K.A.J.
        • Franklyn-Miller A.
        • Falvey E.
        • Myer G.D.
        • et al.
        Biomechanical but not strength or performance measures differentiate male athletes who experience ACL reinjury on return to Level 1 sports.
        Am J Sports Med. 2021 Mar; 49: 918-927
        • Paterno M.V.
        • Schmitt L.C.
        • Ford K.R.
        • Rauh M.J.
        • Myer G.D.
        • Huang B.
        • et al.
        Biomechanical measures during landing and postural stability predict second anterior cruciate ligament injury after anterior cruciate ligament reconstruction and return to sport.
        Am J Sports Med. 2010 Oct; 38: 1968-1978
        • Koga H.
        • Nakamae A.
        • Shima Y.
        • Iwasa J.
        • Myklebust G.
        • Engebretsen L.
        • et al.
        Mechanisms for noncontact anterior cruciate ligament injuries: knee joint kinematics in 10 injury situations from female team handball and basketball.
        Am J Sports Med. 2010 Nov; 38: 2218-2225
        • Kiapour A.M.
        • Quatman C.E.
        • Goel V.K.
        • Wordeman S.C.
        • Hewett T.E.
        • Demetropoulos C.K.
        Timing sequence of multi-planar knee kinematics revealed by physiologic cadaveric simulation of landing: implications for ACL injury mechanism.
        Clin Biomech. 2014 Jan; 29: 75-82
        • Ueno R.
        • Navacchia A.
        • Schilaty N.D.
        • Myer G.D.
        • Hewett T.E.
        • Bates N.A.
        Anterior cruciate ligament loading increases with pivot-shift mechanism during asymmetrical drop vertical jump in female athletes.
        Orthop J Sports Med. 2021 Mar 9; 92325967121989095
        • Asaeda M.
        • Nakamae A.
        • Hirata K.
        • Kono Y.
        • Uenishi H.
        • Adachi N.
        Factors associated with dynamic knee valgus angle during single-leg forward landing in patients after anterior cruciate ligament reconstruction.
        Asia Pac J Sports Med Arthrosc Rehabil Technol. 2020 Aug 24; 22: 56-61
        • Kanaya A.
        • Ochi M.
        • Deie M.
        • Adachi N.
        • Nishimori M.
        • Nakamae A.
        Intraoperative evaluation of anteroposterior and rotational stabilities in anterior cruciate ligament reconstruction: lower femoral tunnel placed single-bundle versus double-bundle reconstruction.
        Knee Surg Sports Traumatol Arthrosc. 2009 Aug; 17: 907-913
        • Nakamae A.
        • Ochi M.
        • Deie M.
        • Adachi N.
        • Shibuya H.
        • Ohkawa S.
        • et al.
        Clinical outcomes of second-look arthroscopic evaluation after anterior cruciate ligament augmentation: comparison with single- and double-bundle reconstruction.
        Bone Joint Lett J. 2014 Oct; 96-B: 1325-1332
        • Ochi M.
        • Abouheif M.M.
        • Kongcharoensombat W.
        • Nakamae A.
        • Adachi N.
        • Deie M.
        Double bundle arthroscopic anterior cruciate ligament reconstruction with remnant preserving technique using a hamstring autograft.
        Sports Med Arthrosc Rehabil Ther Technol. 2011 Dec 5; 3: 30
        • Ochi M.
        • Adachi N.
        • Uchio Y.
        • Deie M.
        • Kumahashi N.
        • Ishikawa M.
        • et al.
        A minimum 2-year follow-up after selective anteromedial or posterolateral bundle anterior cruciate ligament reconstruction.
        Arthroscopy. 2009 Feb; 25: 117-122
        • Ochi M.
        • Adachi N.
        • Deie M.
        • Kanaya A.
        Anterior cruciate ligament augmentation procedure with a 1-incision technique: anteromedial bundle or posterolateral bundle reconstruction.
        Arthroscopy. 2006 Apr; 22: 463.e1-463.e5
        • Andriacchi T.P.
        • Alexander E.J.
        • Toney M.K.
        • Dyrby C.
        • Sum J.
        A point cluster method for in vivo motion analysis: applied to a study of knee kinematics.
        J Biomech Eng. 1998 Dec; 120: 743-749
        • Mandrekar J.N.
        Receiver operating characteristic curve in diagnostic test assessment.
        J Thorac Oncol. 2010 Sep; 5: 1315-1316
        • Krosshaug T.
        • Steffen K.
        • Kristianslund E.
        • Nilstad A.
        • Mok K.M.
        • Myklebust G.
        • et al.
        The vertical drop jump is a poor screening test for ACL injuries in female elite soccer and handball players: a prospective cohort study of 710 athletes.
        Am J Sports Med. 2016 Apr; 44: 874-883
        • Leppänen M.
        • Pasanen K.
        • Kujala U.M.
        • Vasankari T.
        • Kannus P.
        • Äyrämö S.
        • et al.
        Stiff landings are associated with increased ACL injury risk in young female basketball and floorball players.
        Am J Sports Med. 2017 Feb; 45: 386-393
        • Johnston P.T.
        • McClelland J.A.
        • Webster K.E.
        Lower limb biomechanics during single-leg landings following anterior cruciate ligament reconstruction: a systematic review and meta-analysis.
        Sports Med. 2018 Sep; 48: 2103-2126
        • Webster K.E.
        • Gonzalez-Adrio R.
        • Feller J.A.
        Dynamic joint loading following hamstring and patellar tendon anterior cruciate ligament reconstruction.
        Knee Surg Sports Traumatol Arthrosc. 2004 Jan; 12: 15-21
        • Webster K.E.
        • Feller J.A.
        Tibial rotation in anterior cruciate ligament reconstructed knees during single limb hop and drop landings.
        Clin Biomech. 2012 Jun; 27: 475-479
        • Tengman E.
        • Grip H.
        • Stensdotter A.
        • Häger C.K.
        Anterior cruciate ligament injury about 20 years post-treatment: a kinematic analysis of one-leg hop.
        Scand J Med Sci Sports. 2015 Dec; 25: 818-827
        • Nagelli C.
        • Wordeman S.
        • Di Stasi S.
        • Hoffman J.
        • Marulli T.
        • Hewett T.E.
        Biomechanical deficits at the hip in athletes with ACL reconstruction are ameliorated with neuromuscular training.
        Am J Sports Med. 2018 Sep; 46: 2772-2779
        • Kramer L.C.
        • Denegar C.R.
        • Buckley W.E.
        • Hertel J.
        Factors associated with anterior cruciate ligament injury: history in female athletes.
        J Sports Med Phys Fit. 2007 Dec; 47: 446-454
        • Norouzi S.
        • Esfandiarpour F.
        • Mehdizadeh S.
        • Yousefzadeh N.K.
        • Parnianpour M.
        Lower extremity kinematic analysis in male athletes with unilateral anterior cruciate reconstruction in a jump-landing task and its association with return to sport criteria.
        BMC Muscoskel Disord. 2019 Oct 27; 20: 492
        • Capin J.J.
        • Khandha A.
        • Buchanan T.S.
        • Snyder-Mackler L.
        Partial medial meniscectomy leads to altered walking mechanics two years after anterior cruciate ligament reconstruction: meniscal repair does not.
        Gait Posture. 2019 Oct; 74: 87-93