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Inicio Revista Española de Cirugía Ortopédica y Traumatología (English Edition) Kinetic protocol in torn anterior cruciate ligament
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Vol. 55. Núm. 1.
Páginas 9-18 (enero - febrero 2011)
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Vol. 55. Núm. 1.
Páginas 9-18 (enero - febrero 2011)
Original article
Acceso a texto completo
Kinetic protocol in torn anterior cruciate ligament
Protocolo cinético en la rotura del ligamento cruzado anterior
Visitas
1751
G. López Hernándeza,
Autor para correspondencia
glorialopezhernandez@fremap.es

Corresponding author.
, L. Fernández Hortigüelaa, J.L. Gutiérreza, F. Forriolb, Project subsidized by the SECOT Foundation
a Hospital FREMAP Majadahonda, Madrid, Spain
b Universidad CEU-San Pablo, Montepríncipe, Madrid, Spain
Este artículo ha recibido
Información del artículo
Abstract
Objective

To kinetically evaluate patients with a torn anterior cruciate ligament (ACL) fracture in order to establish a biomechanical assessment and follow-up protocol.

Patients and methods

A total of 45 males, with a mean age of 34 years and an isolated torn ACL or associated with a torn meniscus, were assessed before surgery. Walking, sprinting and jump tests were performed to assess the floor reaction forces, comparing the injured side with the healthy or control side. The force parameters for each of the movements were obtained and analysed.

Results

We obtained differences in the support forces in different tests, particularly in the jumps. The single-legged jump decreased the vertical support strength and increased the support time in the injured leg, and the jump time was half with a torn ACL. In the vertical jump, the vertical propulsion force and also the support time of the injured side decreased. In the drop and push jump, the vertical drop force and the vertical push force decreased.

Conclusions

The torn ACL affects the movement kinetics, particularly in the jump tests. A kinetic protocol would be useful for assessing torn ACL and their outcome after surgery.

Keywords:
Anterior cruciate ligament
Biomechanics
Kinetics
Jump
Knee
Resumen
Objetivo

Evaluar cinéticamente pacientes con una rotura del ligamento cruzado anterior (LCA) para establecer un protocolo biomecánico de evaluación y seguimiento.

Pacientes y metodología

Se estudiaron 45 pacientes varones, con una media de 34 años y rotura aislada del LCA o asociado a rotura de menisco, antes de la cirugía. Realizaron pruebas de marcha, “sprint” y salto para valorar las fuerzas de reacción con el suelo, comparando el lado lesionado con el sano o control. Se obtuvieron y analizaron los parámetros de fuerza de cada uno de los movimientos.

Resultados

Obtuvimos diferencias en las fuerzas de apoyo en diferentes pruebas, especialmente en los saltos. En el salto monopodal disminuyó la fuerza vertical de apoyo, aumentó el tiempo de apoyo, en la pierna lesionada y el tiempo del salto fue la mitad con una rotura del LCA. En el salto vertical disminuyó la fuerza vertical de impulso y también el tiempo de apoyo del lado lesionado. En el salto con caída e impulso disminuyó la fuerza vertical de caída y la fuerza vertical de impulso.

Conclusiones

La rotura del LCA afecta a la cinética del movimiento, especialmente en las pruebas de salto. Un protocolo cinético puede ser útil para valorar la rotura del LCA y su evolución tras la cirugía.

Palabras clave:
Ligamento cruzado anterior
Biomecánica
Cinética
Salto
Rodilla
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References
[1.]
K.C. Miyasaka, D.M. Daniel, M.L. Stone.
The incidence of knee ligament injuries in the general population.
Am J Knee Surg, 4 (1991), pp. 43-48
[2.]
F.R. Noyes, D.L. Butler, L.E. Paulos, E.S. Grood.
Intra-articular cruciate reconstructions. 1. Perspectives on graft strength, vascularization and immediate motion after replacement.
Clin Orthop Rel Res, 172 (1983), pp. 71-76
[3.]
R.B. Marx, E.C. Jones, M. Angel, T.L. Wickiewicz, R.F. Warren.
Beliefs and attitudes of members of the American Academy of Orthopedic Surgeons regarding the treatment of anterior cruciate ligament injury.
Arthroscopy, 19 (2003), pp. 762-770
[4.]
M. Odensten, J. Gillquist.
Functional anatomy of the anterior cruciate ligament and a rationale for reconstruction.
J Bone Joint Surg (Am), 67-A (1985), pp. 257-262
[5.]
F.G. Girgis, J.L. Marshall, A. Monajem.
The cruciate ligaments of the knee joint. Anatomical, functional and experimental analysis.
Clin Orthop Rel Res, 106 (1975), pp. 216-231
[6.]
L.A. Norwood, M.M. Cross.
Anterior cruciate ligament: functional anatomy of its bundles in rotatory instabilities.
Am J Sports Med, 7 (1979), pp. 23-26
[7.]
A.A. Amis, P.C. Dawkins.
Functional anatomy of the anterior cruciate ligament: fibre bundle actions related to ligament replacements and injuries.
J Bone Joint Surg (Br), 73-B (1991), pp. 260-267
[8.]
A. Maestro, A. Álvarez, M. del Valle, L. Rodríguez, P. García, J. Fernández Lombardía.
La reconstrucción anatómica bifascicular del LCA con único túnel tibial.
Cuadernos Artroscopia, 15 (2008), pp. 20-29
[9.]
P. Christel, A. Sahasrabudhe, G. Basdekis.
Anatomic doublebundle anterior cruciate ligamento reconstruction with anatomic aimers.
Arthroscopy, 24 (2008), pp. 1146-1151
[10.]
F.R. Noyes, D.L. Butler, E.S. Grood, R.F. Zernicke, M.S. Hefzy.
Biomechanical analysis of human ligament grafts used in kneeligament repairs and reconstructions.
J Bone Joint Surg (Am), 66-A (1984), pp. 344-352
[11.]
G. Rauch, B. Allzeit, L. Gotzen.
Biomechanische Untersuchungen zur Zugfestigkeit des vorderen Kreuzbandes unter besonderer Berucksichtigung der Altersabhangigkeit.
Unfallchirurg, 91 (1988), pp. 437-443
[12.]
S.L.Y. Woo, T. Vogrin, S. Abramowitch.
Healing and repair of ligament injuries in the knee.
J Am Acad Ortho Surg, 8 (2000), pp. 364-372
[13.]
J.B. Morrison.
The mechanics of the knee in relation to normal walking.
J Biomech, 3 (1970), pp. 51-61
[14.]
L. Pugh, R. Mascarenhas, S. Arneja, P.Y.K. Chin, J.M. Leith.
Current concepts in instrumented knee-laxity testing.
Am J Sports Med, 37 (2009), pp. 199-210
[15.]
T.P. Andriacchi, C.O. Dirby.
Interactions between kinematics and loading during walking for the normal and ACL deficiente knee.
J Biomech, 38 (2005), pp. 293-328
[16.]
R. Shiavi, T. Limbird, M. Frazer, K. Stivers, A. Strauss, J. Abramovitz.
Helical motion analysis of the knee. II Kinematics of uninjured and injured knees during walking and pivoting.
J Biomech, 20 (1987), pp. 653-665
[17.]
T.P. Andriacchi, D. Birac.
Functional testing in the anterior cruciate ligament-deficient knee.
Clin Orthop Rel Res, 288 (1993), pp. 40-47
[18.]
P. DeVita, T. Hortobagyi, J. Barrier.
Gait biomechanics are not normal after anterior cruciate ligament reconstruction and accelerated rehabilitation.
Med Sci Sports Exerc, 30 (1998), pp. 1481-1488
[19.]
K. Rudolph, M. Axe, T. Buchanan, J. Scholz, L. Snyder-Mackler.
Dynamic stability in the anterior cruciate ligament deficient knee.
Knee Surg Sports Traumatol Arthrosc, 9 (2001), pp. 62-71
[20.]
K. Kaufman, C. Hughes, B. Morrey, M. Morrey, K. An.
Gait characteristics of patients with knee osteoarthritis.
J Biomech, 34 (2001), pp. 907-915
[21.]
D. Hurwitz, A. Ryals, J. Block, L. Sharma, T. Schnitzer, T. Andriacchi.
Knee pain and joint loading in subjects with osteoarthritis of the knee.
J Orthop Res, 18 (2000), pp. 572-579
[22.]
A. Smith, D. Lloyd, D. Wood.
A kinematic and kinetic analysis of walking after total knee arthroplasty with and without patellar resurfacing.
Clin Biomech (Bristol, Avon), 21 (2006), pp. 379-386
[23.]
A. Durand, C. Richards, F. Malouin, G. Bravo.
Motor recovery after arthroscopic partial meniscectomy. Analyses of gait and the ascent and descent of stairs.
J Bone Joint Surg (Am), 75-A (1993), pp. 202-214
[24.]
M.E. Eastlack, M.J. Axe, L. Snyder-Mackler.
Laxity, instability, and functional outcome after ACL injury: copers versus noncopers.
Med Sci Sports Exerc, 31 (1999), pp. 210-215
[25.]
M.R. Torry, M.J. Decker, H.B. Ellis, K.B. Shelburne, W.I. Sterett, J.R. Steadman.
Mechanisms of compensanting for anterior cruciate ligament deficiency during gait.
Med Sci Sports Exerc, 36 (2004), pp. 1403-1412
[26.]
B. Beynnon, J. Howe, M. Pope, R. Johnson, B. Fleming.
The measurement of anterior cruciate ligament strain in vivo.
Int Orthop, 16 (1992), pp. 1-12
[27.]
M. Berchuck, T.P. Andriacchi, B.R. Bach, B. Reider.
Gait adaptations by patients who have a deficient anterior cruciate ligament.
J Bone Joint Surg (Am), 72-A (1990), pp. 871-877
[28.]
J.M. Timoney, W.S. Inman, P.M. Quesada, P.F. Sharkey, R.L. Barrack, H.B. Skinner, et al.
Return of normal gait patterns after anterior cruciate ligament reconstruction.
Am J Sports Med, 21 (1993), pp. 887-889
[29.]
R. Ferber, L.R. Osternig, M.H. Woollacott, N.J. Wasielewski, J.H. Lee.
Gait perturbation response response in anterior cruciate ligament deficiency and surgery.
Clin Biomech (Bristol Avon), 18 (2003), pp. 132-141
[30.]
A.K. Aune, I. Holm, M.A. Risberg, H.K. Jensen, H. Steen.
Four-strand hamstring tendon autograft compared with patellar tendonbone autograft for anterior cruciate ligament reconstruction. A randomized study with two-year follow-up.
Am J Sports Med, 29 (2001), pp. 722-728
[31.]
D. Beard, J. Anderson, S. Davies, A. Price, C. Dodd.
Hamstrings vs patella tendon for anterior cruciate ligament reconstruction: a randomised controlled trial.
Knee, 8 (2001), pp. 45-50
[32.]
L. Ejerhed, J. Kartus, N. Sernert, K. Köhler, J. Karlsson.
Patellar tendon or semitendinous tendon autografts for anterior cruciate ligament reconstruction?.
Am J Sports Med, 31 (2003), pp. 19-25
[33.]
J. Feller, K. Webster, B. Gavin.
Early post-operative morbidity following anterior cruciate ligament reconstruction: patellar tendon versus hamstring graft.
Knee Surg Sports Traumatol Arthrosc, 9 (2001), pp. 260-266
[34.]
L.A. Hiemstra, S. Weber, P.B. MacDonald, D.J. Kriellaars.
Knee strength deficits after hamstring tendon and patellar tendon anterior cruciate ligament reconstruction.
Med Sci Sports Exerc, (2000), pp. 1472-1479
[35.]
C. Mikkelsen, S. Werner, E. Eriksson.
Closed kinetic chain alone compared to combined open and closed kinetic chain exercises for quadriceps strengthening after anterior cruciate ligament reconstruction with respect to return to sports: a prospective matched follow-up study.
Knee Surg Sports Traumatol Arthrosc, 8 (2000), pp. 337-342
[36.]
Y. Makihara, A. Nishino, T. Fukubayashi, A. Kanamori.
Decrease of knee flexion torque in patients with ACL reconstruction: combined analysis of the architecture and function of the knee flexor muscles.
Knee Surg Sports Traumatol Arthrosc, 14 (2006), pp. 310-317
[37.]
N. Nakamura, S. Horibe, S. Sasaki, T. Kitaguchi, M. Tagami, T. Mitsuoka, et al.
Evaluation of active knee flexion and hamstring strength after anterior cruciate ligament reconstruction using hamstring tendons.
Arthroscopy, 18 (2002), pp. 598-602
[38.]
T. Tashiro, H. Kurosawa, A. Kawakami, A. Hikita, N. Fukui.
Influence of medial hamstring tendon harvest on knee flexor strength after anterior cruciate ligament reconstruction: a detailed evaluation with comparison of single- and double-tendon harvest.
Am J Sports Med, 31 (2003), pp. 522-529
[39.]
G. Wexler, D.E. Hurwitz, C.A. Bush-Joseph, T.P. Andriacchi, B.R. Bach.
Functional gait adaptations in individuals with anterior cruciate ligament deficiency over time.
Clin Orthop Relat Res, 348 (1998), pp. 166-175
[40.]
M. Lindström, L. Felländer-Tsai, T. Wredmark, M. Henriksson.
Adaptations of gait and muscle activation in chronic ACL deficiency.
Knee Surg Sports Traumatol Arthrosc, 18 (2010), pp. 106-114
[41.]
P. Bulgheroni, M.V. Bulgheroni, L. Andrini, P. Guffanti, A. Giughello.
Gait patterns after anterior cruciate ligament reconstruction.
Knee Surg Sports Traumatol Arthroc, 5 (1997), pp. 14-21
[42.]
K.S. Rudolph, M.J. Axe, L. Snyder-Mackler.
Dynamic stability after ACL injury: who can hop?.
Knee Surg Sports Traumatol Arthrosc, 8 (2000), pp. 262-269
[43.]
P. Edixhoven, R. Huiskes, R. de Graaf.
Anteroposterior drawer measurements in the knee using an instrumented test device.
Clin Orthop Relat Res, 247 (1989), pp. 232-242
[44.]
M.R. Yeadon, M.A. King, S.E. Forrester, G.E. Caldwell, M.T.G. Pain.
The need for muscle co-contraction prior to a landing.
J Biomech, 43 (2010), pp. 364-369
[45.]
K.R. Ford, G.D. Myer, T.E. Hewett.
Reliability of landing 3D motion analysis: implications for longitudinal analyses.
Med Sci Sports Exerc, 39 (2007), pp. 2021-2028
[46.]
D.A. Padua, S.W. Marshall, M.C. Boling, C.A. Thigpen, W.E. Garrett, A.I. Beutler.
The landing error scoring system (LESS) is a valid and reliable clinical assessment tool of jump-landing biomechanics. The JUMP-ACL study.
Am J Sports Med, 37 (2009), pp. 1996-2002
[47.]
I. Sekiya, T. Muneta, T. Ogiuchi.
Significance of the single-legged hop test to the anterior cruciate ligament-reconstructed knee in relation to muscle strength and anterior laxity.
Am J Sports Med, 26 (1998), pp. 384-388
[48.]
R.A. Sachs, D.M. Daniel, M.L. Stone, R.F. Garfein.
Patellofemoral problems after anterior cruciate ligament reconstruction.
Am J Sports Med, 7 (1989), pp. 760-765
[49.]
K.E. Wilk, W.T. Romaniello, S.M. Soscia, C.A. Arrigo, J.R. Andrews.
The relationship between subjective knee scores, isokinetic testing and functional testing in the ACL-reconstructed knee.
J Orthop Sports Phys Ther, 20 (1994), pp. 60-73
[50.]
C.S. Shin, A.M. Chaudhari, T.P. Andriacchi.
The influence of decelaration forces on ACL strain during single-leg landing: a simulation study.
J Biomechanics, 40 (2007), pp. 1145-1152
[51.]
E. Ageberg, T. Friden.
Normalized motor function but impaired sensory function after unilateral non-reconstructed ACL injury: patients compared with uninjured controls.
Knee Surg Sports Traumatol Arthroc, 16 (2008), pp. 449-456
[52.]
P. Samozino, J.-B. Morin, F. Hintzy, A. Belli.
A simple method for measuring force, velocity and power output during squat jump.
J Biomech, 41 (2008), pp. 2940-2945
[53.]
M.V. Paterno, K.R. Fprd, G.D. Myer, R. Heyl, T.E. Hewett.
Limb asymmetries in landing and jumping 2 years following anterior cruciate ligament reconstruction.
Clin J Sport Med, 17 (2007), pp. 258-262
[54.]
R.B. Frobell, H.P. Roos, E.M. Roos, M.P. Hellio Le Graverand, R. Buck, et al.
The acutely ACL injured knee assessed by MRI: are large volume traumatic bone marrow lesions a sign of severe compression injury?.
Osteoarthritis Cartilage, 16 (2008), pp. 829-836
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