Caroline Lisee, Shelby Baez, Elizabeth Bjornsen, Louise Thoma, Troy Blackburn, Jeffrey T Spang, R Alexander Creighton, Ganesh Kamath, Jessica Hu, Brian Pietrosimone
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引用次数: 0
Abstract
Background: Aberrant gait biomechanics-ie, lower knee abduction moment (KAM) impulse- are linked to the development of posttraumatic osteoarthritis after anterior cruciate ligament (ACL) injury and ACL reconstruction (ACLR). There is a clinical need to identify modifiable factors, such as kinesiophobia and pain, that may contribute to aberrant gait development after ACLR to advance multimodal rehabilitation strategies.
Purpose/hypothesis: This study aimed to determine associations between preoperative kinesiophobia and pain and gait biomechanics linked to posttraumatic osteoarthritis development at 2 and 4 months after ACLR. We hypothesized that worse preoperative kinesiophobia and pain would be associated with lower KAM impulses in the ACLR limb but not the uninjured limb at 2 and 4 months after ACLR.
Study design: Cohort study; Level of evidence, 2.
Methods: Patients within 6 weeks of ACL injury and planning to undergo ACLR with bone-patellar tendon-bone autografts were recruited for the study. Preoperatively, participants completed the Tampa Scale of Kinesiophobia (TSK-11) and Knee injury and Osteoarthritis Outcome Score Pain (KOOS Pain) subscale surveys to assess kinesiophobia (ie, psychological component to pain) and knee pain, respectively. Participants returned at 2 and 4 months after ACLR to complete a 3-dimensional gait biomechanics analysis. KAM impulses during the stance phase were calculated (N*m*s/N*m) for both limbs. Associations of preoperative TSK-11 and KOOS Pain scores with KAM impulses in ACLR and uninjured limbs were analyzed using separate linear regressions.
Results: A total of 36 participants (58% women; mean age, 21.4 ± 4.31 years; body mass index, 24.1 ± 3.59 kg/m2 ) completed 3 study visits. Higher preoperative kinesiophobia was associated with lower KAM impulses in the ACLR limb (R2 = 0.14; P = .02) but not the uninjured limb (R2 = 0.01; P = .58) at 4 months after ACLR. Preoperative KOOS Pain scores were not associated with KAM impulses in the ACLR and uninjured limbs at 2 and 4 months after ACLR (ΔR2 range, <0.01-0.02; P range = .53-.90).
Conclusion: Preoperative kinesiophobia, but not pain, was weakly associated with lower KAM impulses during early to midphases of clinical recovery at 4 months after ACLR.
期刊介绍:
The Orthopaedic Journal of Sports Medicine (OJSM), developed by the American Orthopaedic Society for Sports Medicine (AOSSM), is a global, peer-reviewed, open access journal that combines the interests of researchers and clinical practitioners across orthopaedic sports medicine, arthroscopy, and knee arthroplasty.
Topics include original research in the areas of:
-Orthopaedic Sports Medicine, including surgical and nonsurgical treatment of orthopaedic sports injuries
-Arthroscopic Surgery (Shoulder/Elbow/Wrist/Hip/Knee/Ankle/Foot)
-Relevant translational research
-Sports traumatology/epidemiology
-Knee and shoulder arthroplasty
The OJSM also publishes relevant systematic reviews and meta-analyses.
This journal is a member of the Committee on Publication Ethics (COPE).