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Knee kinematics and joint moments during gait following anterior cruciate ligament reconstruction: a systematic review and meta-analysis

2015; BMJ; Volume: 50; Issue: 10 Linguagem: Inglês

10.1136/bjsports-2015-094797

1473-0480

Harvi F. Hart, Adam G. Culvenor, Natalie J. Collins, David C. Ackland, S. Cowan, Zuzana Machotka, Kay M. Crossley,

Lower Extremity Biomechanics and Pathologies

Abnormal gait after anterior cruciate ligament reconstruction (ACLR) may contribute to development and/or progression of knee osteoarthritis.To conduct a systematic review and meta-analysis of knee kinematics and joint moments during walking after ACLR.We searched seven electronic databases and reference lists of relevant papers, for cross-sectional, human-based observational studies comparing knee joint kinematics and moments during level walking in individuals with ACLR, with the uninjured contralateral knee or healthy individuals as a control. Two independent reviewers appraised methodological quality (modified Downs and Black scale). Where possible, data were pooled by time post-ACLR (RevMan), otherwise narrative synthesis was undertaken.Thirty-four studies were included. Meta-analysis revealed significant sagittal plane deficits in ACLR knees. We found greater knee flexion angles (standardised mean difference: 1.06; 95% CI 0.39 to 1.74) and joint moments (1.61; 0.87 to 2.35) 3 years after ACLR (vs healthy controls) (0.09; -0.63 to 0.81). No transverse plane conclusions could be drawn.Sagittal plane biomechanics, rather than the knee adduction moment, appear to be more relevant post-ACLR. Better understanding of sagittal plane biomechanics is necessary for optimal post-operative recovery, and to potentially prevent early onset and progression of knee OA after ACLR.PROSPERO systematic review protocol registration number CRD4201400882 2.