A High-Riding Patella Is a Feature of Knee Joint Motion During Gait After ACL Reconstruction

IF 2.1 3区 医学 Q2 ORTHOPEDICS
Marcus G. Pandy, Hans A. Gray, Padma N. Ganapam, Adam G. Culvenor, Kay M. Crossley, Shanyuanye Guan
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引用次数: 0

Abstract

Accurate measurements of knee joint motion during gait after anterior cruciate ligament reconstruction (ACLR), especially for the patellofemoral joint, are sparse. The aim of this study was to measure six-degree-of-freedom (6-DOF) patellofemoral and tibiofemoral motion in ACLR and uninjured contralateral knees during gait, and to compare these results to healthy (control) knees. Biplane fluoroscopy was used to measure 6-DOF patellofemoral and tibiofemoral motion in 15 ACLR participants (26.3 ± 3.9 years) for complete cycles of level walking and downhill walking, and the results were compared to data for 10 healthy individuals (29.8 ± 6.1 years). Mean patellar superior translation, anterior translation, and flexion over the gait cycle were respectively 4.4–5.6 mm greater, 5.4–6.3 mm greater, and 3.7°–7.0° less in the ACLR and contralateral knees compared to controls across both activities (p < 0.021). Articular contact was 7.6 mm higher on the femoral trochlea in the ACLR and contralateral knees compared to controls. The patellar tendon was 8.9 mm longer (p < 0.001) in the ACLR and contralateral knees compared to controls. Among ACLR participants, 14 out of 30 knees (47%) had an Insall–Salvati ratio ≥ 1.20, indicating patella alta. Mean tibial external rotation and anterior translation over the gait cycle were respectively 3.4°–3.8° greater and 2.6–3.0 mm greater in the ACLR knee compared to controls across both activities (p < 0.025). A high-riding patella in both knees of the ACLR participants was due to a longer patellar tendon. A change in the load-bearing areas of the femoral trochlea may contribute to the high rate of patellofemoral osteoarthritis seen after ACLR.

Abstract Image

高位髌骨是前交叉韧带重建后步态中膝关节运动的一个特征。
前交叉韧带重建(ACLR)后步态中膝关节运动的精确测量,特别是髌股关节,是稀疏的。本研究的目的是测量ACLR和未受伤的对侧膝关节在步态过程中的六自由度(6-DOF)髌股和胫股运动,并将这些结果与健康(对照)膝关节进行比较。采用双平面透视测量15名ACLR参与者(26.3±3.9岁)水平行走和下坡行走完整周期的6自由度髌骨和胫股运动,并将结果与10名健康个体(29.8±6.1岁)的数据进行比较。在步态周期内,与对照组相比,ACLR和对侧膝关节的平均髌骨上平移、前平移和屈曲分别增加4.4-5.6 mm、5.4-6.3 mm和3.7°-7.0°
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来源期刊
Journal of Orthopaedic Research®
Journal of Orthopaedic Research® 医学-整形外科
CiteScore
6.10
自引率
3.60%
发文量
261
审稿时长
3-6 weeks
期刊介绍: The Journal of Orthopaedic Research is the forum for the rapid publication of high quality reports of new information on the full spectrum of orthopaedic research, including life sciences, engineering, translational, and clinical studies.
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