Copers and Noncopers Use Different Landing Techniques to Limit Anterior Tibial Translation After Anterior Cruciate Ligament Reconstruction

Overview

Journal Orthop J Sports Med

Specialty Orthopedics

Date 2021 May 5

PMID 33948445

Citations 3

Authors

Michele N J Keizer

Egbert Otten

Chantal M I Beijersbergen

Reinoud W Brouwer

Juha M Hijmans

Affiliations

Soon will be listed here.

Abstract

Background: At 1 year after anterior cruciate ligament reconstruction (ACLR), two-thirds of patients manage to return to sports (copers), whereas one-third of patients do not return to sports (noncopers). Copers and noncopers have different muscle activation patterns, and noncopers may not be able to control dynamic anterior tibial translation (ATTd) as well as copers.

Purpose/hypothesis: To investigate whether (1) there is a positive correlation between passive ATT (ATTp; ie, general joint laxity) and ATTd during jump landing, (2) whether ATTd is moderated by muscle activating patterns, and (3) whether there is a difference in moderating ATTd between copers and noncopers. We hypothesized that patients who have undergone ACLR compensate for ATTd by developing muscle strategies that are more effective in copers compared with noncopers.

Study Design: Controlled laboratory study.

Methods: A total of 40 patients who underwent unilateral ACLR performed 10 single-leg hops for distance with both legs. Lower body kinematic and kinetic data were measured using a motion-capture system, and ATTd was determined with an embedded method. Muscle activity was measured using electromyographic signals. Bilateral ATTp was measured using a KT-1000 arthrometer. In addition, the Beighton score was obtained.

Results: There was no significant correlation between ATTp and ATTd in copers; however, there was a positive correlation between ATTp and ATTd in the operated knee of noncopers. There was a positive correlation between the Beighton score and ATTp as well as between the Beighton score and ATTd in both copers and noncopers in the operated knee. Copers showed a negative correlation between ATTd and gastrocnemius activity in their operated leg during landing. Noncopers showed a positive correlation between ATTd and knee flexion moment in their operated knee during landing.

Conclusion: Copers used increased gastrocnemius activity to reduce ATTd, whereas noncopers moderated ATTd by generating a smaller knee flexion moment.

Clinical Relevance: This study showed that copers used different landing techniques than noncopers. Patients who returned to sports after ACLR had sufficient plantar flexor activation to limit ATTd.

Citing Articles

Multi-planar instability, laxity and reduced knee flexion during the support phase of walking are determinants of return to sports.

Zhou T, Xu Y, Zhou L, Wang S, Wang S, Xu W Front Bioeng Biotechnol. 2022; 10:1047135.

PMID: 36406209 PMC: 9669481. DOI: 10.3389/fbioe.2022.1047135.

Meniscal resection increases the risk of residual knee laxity even in patients undergoing anatomic double-bundle anterior cruciate ligament reconstruction with eight strands of hamstring autografts.

Ye Z, Wu C, Xu J, Chen J, Qiao Y, Wu X Knee Surg Sports Traumatol Arthrosc. 2022; 31(7):2784-2793.

PMID: 36378292 DOI: 10.1007/s00167-022-07231-9.

Adult patients with ACL tears have greater tibial internal rotation in MRI compared to adolescent patients.

Hong C, Lin Y, Cheng T, Chang C, Hsu K, Kuan F J Orthop Surg Res. 2022; 17(1):17.

PMID: 35016704 PMC: 8753912. DOI: 10.1186/s13018-022-02912-0.

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