Anterior cruciate ligament reconstruction improves subjective ability but not neuromuscular biomechanics during dynamic tasks

Kenneth B Smale; Teresa E Flaxman; Tine Alkjær; Erik Bruun Simonsen; Michael R. Krogsgaard; Daniel L. Benoit

doi:10.1007/s00167-018-5189-7

Anterior cruciate ligament reconstruction improves subjective ability but not neuromuscular biomechanics during dynamic tasks

Kenneth B Smale, Teresa E Flaxman, Tine Alkjær, Erik Bruun Simonsen, Michael R. Krogsgaard, Daniel L. Benoit

3 Citations (Scopus)

Abstract

PURPOSE: The purpose of this study was to identify high-functioning anterior cruciate ligament-deficient patients and assess the effects of reconstruction on their self-reported functionality, muscle activations and biomechanical properties.

METHODS: Twenty young and active patients participated pre- (11.5 ± 14.3 months post-injury) and again 10.5 ± 1.7 months post-reconstruction and were individually matched to 20 healthy controls. Participants completed hop and side cut movements while patient-related outcome measures, lower limb electromyography, kinetic, and whole body kinematic data were collected. One-dimensional statistical parametric mapping was used to test for group differences (healthy vs deficient; deficient vs reconstructed; reconstructed vs healthy).

RESULTS: When comparing healthy to anterior cruciate ligament-deficient participants, all questionnaires indicated significant lower subjective function while the only substantial biomechanical difference between these participants was a decreased knee extensor moment in both the hop (peak difference: 0.63 Nm/kg, p < 0.001) and side cut (peak difference: 0.76 Nm/kg, p < 0.001). When comparing patients' pre- and post-reconstruction, no biomechanical differences were observed whereas only half of the questionnaires (Tegner, Lysholm, KNEES-ADL, KNEES-Slackness, KNEES-Looseness, KNEES-Sport Behaviour, IKDC, and KOOS-QoL) indicated higher function in the reconstructed state. When comparing the reconstructed patients to the healthy participants, all questionnaires were still significantly higher in the healthy controls. The reconstructed group also had a smaller flexion angle (peak difference: 14.5°, p = 0.007) and knee extensor moment (peak difference: 0.62 Nm/kg, p < 0.001) during the hop and a smaller knee extensor moment (peak difference: 0.90 Nm/kg, p < 0.001) during the side-cut task.

CONCLUSION: At 10-months post-reconstruction, the current results indicate that in high-functioning anterior cruciate ligament-deficient patients, reconstruction had little impact on objective measures of functional ability during dynamic tasks although self-reported function was improved.

LEVEL OF EVIDENCE: Therapeutic prospective cohort study, Level II.

Original language	English
Journal	Knee Surgery, Sports Traumatology, Arthroscopy
Volume	27
Issue number	2
Pages (from-to)	636-645
Number of pages	10
ISSN	0942-2056
DOIs	https://doi.org/10.1007/s00167-018-5189-7
Publication status	Published - 14 Feb 2019

Keywords

Electromyography
Kinematics
Kinetics
Knee
Patient-reported outcome measures

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10.1007/s00167-018-5189-7

Cite this

@article{688ad6fb53624a9baa1a793d0056ddc4,

title = "Anterior cruciate ligament reconstruction improves subjective ability but not neuromuscular biomechanics during dynamic tasks",

abstract = "PURPOSE: The purpose of this study was to identify high-functioning anterior cruciate ligament-deficient patients and assess the effects of reconstruction on their self-reported functionality, muscle activations and biomechanical properties.METHODS: Twenty young and active patients participated pre- (11.5 ± 14.3 months post-injury) and again 10.5 ± 1.7 months post-reconstruction and were individually matched to 20 healthy controls. Participants completed hop and side cut movements while patient-related outcome measures, lower limb electromyography, kinetic, and whole body kinematic data were collected. One-dimensional statistical parametric mapping was used to test for group differences (healthy vs deficient; deficient vs reconstructed; reconstructed vs healthy).RESULTS: When comparing healthy to anterior cruciate ligament-deficient participants, all questionnaires indicated significant lower subjective function while the only substantial biomechanical difference between these participants was a decreased knee extensor moment in both the hop (peak difference: 0.63 Nm/kg, p < 0.001) and side cut (peak difference: 0.76 Nm/kg, p < 0.001). When comparing patients' pre- and post-reconstruction, no biomechanical differences were observed whereas only half of the questionnaires (Tegner, Lysholm, KNEES-ADL, KNEES-Slackness, KNEES-Looseness, KNEES-Sport Behaviour, IKDC, and KOOS-QoL) indicated higher function in the reconstructed state. When comparing the reconstructed patients to the healthy participants, all questionnaires were still significantly higher in the healthy controls. The reconstructed group also had a smaller flexion angle (peak difference: 14.5°, p = 0.007) and knee extensor moment (peak difference: 0.62 Nm/kg, p < 0.001) during the hop and a smaller knee extensor moment (peak difference: 0.90 Nm/kg, p < 0.001) during the side-cut task.CONCLUSION: At 10-months post-reconstruction, the current results indicate that in high-functioning anterior cruciate ligament-deficient patients, reconstruction had little impact on objective measures of functional ability during dynamic tasks although self-reported function was improved.LEVEL OF EVIDENCE: Therapeutic prospective cohort study, Level II.",

keywords = "Electromyography, Kinematics, Kinetics, Knee, Patient-reported outcome measures",

author = "Smale, {Kenneth B} and Flaxman, {Teresa E} and Tine Alkj{\ae}r and Simonsen, {Erik Bruun} and Krogsgaard, {Michael R.} and Benoit, {Daniel L.}",

year = "2019",

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doi = "10.1007/s00167-018-5189-7",

language = "English",

volume = "27",

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journal = "Knee Surgery, Sports Traumatology, Arthroscopy",

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T1 - Anterior cruciate ligament reconstruction improves subjective ability but not neuromuscular biomechanics during dynamic tasks

AU - Smale, Kenneth B

AU - Flaxman, Teresa E

AU - Alkjær, Tine

AU - Simonsen, Erik Bruun

AU - Krogsgaard, Michael R.

AU - Benoit, Daniel L.

PY - 2019/2/14

Y1 - 2019/2/14

N2 - PURPOSE: The purpose of this study was to identify high-functioning anterior cruciate ligament-deficient patients and assess the effects of reconstruction on their self-reported functionality, muscle activations and biomechanical properties.METHODS: Twenty young and active patients participated pre- (11.5 ± 14.3 months post-injury) and again 10.5 ± 1.7 months post-reconstruction and were individually matched to 20 healthy controls. Participants completed hop and side cut movements while patient-related outcome measures, lower limb electromyography, kinetic, and whole body kinematic data were collected. One-dimensional statistical parametric mapping was used to test for group differences (healthy vs deficient; deficient vs reconstructed; reconstructed vs healthy).RESULTS: When comparing healthy to anterior cruciate ligament-deficient participants, all questionnaires indicated significant lower subjective function while the only substantial biomechanical difference between these participants was a decreased knee extensor moment in both the hop (peak difference: 0.63 Nm/kg, p < 0.001) and side cut (peak difference: 0.76 Nm/kg, p < 0.001). When comparing patients' pre- and post-reconstruction, no biomechanical differences were observed whereas only half of the questionnaires (Tegner, Lysholm, KNEES-ADL, KNEES-Slackness, KNEES-Looseness, KNEES-Sport Behaviour, IKDC, and KOOS-QoL) indicated higher function in the reconstructed state. When comparing the reconstructed patients to the healthy participants, all questionnaires were still significantly higher in the healthy controls. The reconstructed group also had a smaller flexion angle (peak difference: 14.5°, p = 0.007) and knee extensor moment (peak difference: 0.62 Nm/kg, p < 0.001) during the hop and a smaller knee extensor moment (peak difference: 0.90 Nm/kg, p < 0.001) during the side-cut task.CONCLUSION: At 10-months post-reconstruction, the current results indicate that in high-functioning anterior cruciate ligament-deficient patients, reconstruction had little impact on objective measures of functional ability during dynamic tasks although self-reported function was improved.LEVEL OF EVIDENCE: Therapeutic prospective cohort study, Level II.

AB - PURPOSE: The purpose of this study was to identify high-functioning anterior cruciate ligament-deficient patients and assess the effects of reconstruction on their self-reported functionality, muscle activations and biomechanical properties.METHODS: Twenty young and active patients participated pre- (11.5 ± 14.3 months post-injury) and again 10.5 ± 1.7 months post-reconstruction and were individually matched to 20 healthy controls. Participants completed hop and side cut movements while patient-related outcome measures, lower limb electromyography, kinetic, and whole body kinematic data were collected. One-dimensional statistical parametric mapping was used to test for group differences (healthy vs deficient; deficient vs reconstructed; reconstructed vs healthy).RESULTS: When comparing healthy to anterior cruciate ligament-deficient participants, all questionnaires indicated significant lower subjective function while the only substantial biomechanical difference between these participants was a decreased knee extensor moment in both the hop (peak difference: 0.63 Nm/kg, p < 0.001) and side cut (peak difference: 0.76 Nm/kg, p < 0.001). When comparing patients' pre- and post-reconstruction, no biomechanical differences were observed whereas only half of the questionnaires (Tegner, Lysholm, KNEES-ADL, KNEES-Slackness, KNEES-Looseness, KNEES-Sport Behaviour, IKDC, and KOOS-QoL) indicated higher function in the reconstructed state. When comparing the reconstructed patients to the healthy participants, all questionnaires were still significantly higher in the healthy controls. The reconstructed group also had a smaller flexion angle (peak difference: 14.5°, p = 0.007) and knee extensor moment (peak difference: 0.62 Nm/kg, p < 0.001) during the hop and a smaller knee extensor moment (peak difference: 0.90 Nm/kg, p < 0.001) during the side-cut task.CONCLUSION: At 10-months post-reconstruction, the current results indicate that in high-functioning anterior cruciate ligament-deficient patients, reconstruction had little impact on objective measures of functional ability during dynamic tasks although self-reported function was improved.LEVEL OF EVIDENCE: Therapeutic prospective cohort study, Level II.

KW - Electromyography

KW - Kinematics

KW - Kinetics

KW - Knee

KW - Patient-reported outcome measures

U2 - 10.1007/s00167-018-5189-7

DO - 10.1007/s00167-018-5189-7

M3 - Journal article

C2 - 30306241

SN - 0942-2056

VL - 27

SP - 636

EP - 645

JO - Knee Surgery, Sports Traumatology, Arthroscopy

JF - Knee Surgery, Sports Traumatology, Arthroscopy

IS - 2

ER -

Anterior cruciate ligament reconstruction improves subjective ability but not neuromuscular biomechanics during dynamic tasks

Abstract

Keywords

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