To compare dynamic and static tibial translation, in patients with anterior cruciate ligament deficiency, at 2- to 5-year follow-up, with the tibial translation after 4 months of rehabilitation initiated early after the injury. Secondarily, to compare tibial translation in the injured knee and non-injured knee and explore correlations between dynamic and static tibial translation.
Twelve patients with ACL rupture were assessed at 3–8 weeks after ACL injury, after 4 months of structured rehabilitation, and 2–5 years after ACL injury. Sagittal tibial translation was measured during the Lachman test (static translation) and during gait (dynamic translation) using a CA-4000 electrogoniometer.
Static tibial translation was increased bilateral 2–5 years after ACL injury, whereas the dynamic tibial translation was unchanged. Tibial translation was greater in the injured knee compared with the non-injured knee (Lachman test 134 N 9.1 ± 1.0 vs. 7.0 ± 1.7 mm, P = 0.001, gait 5.6 ± 2.1 vs. 4.7 ± 1.8 mm, P = 0.011). There were no correlations between dynamic and static tibial translation.
Dynamic tibial translation was unchanged in spite of increased static tibial translation in the ACL-deficient knee at 2- to 5-year follow-up compared to directly after rehabilitation. Dynamic tibial translation did not correlate with the static tibial translation. A more normal gait kinematics may be maintained from completion of a rehabilitation programme to mid-term follow-up in patients with ACL deficiency treated with rehabilitation only.
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Alkjaer T, Henriksen M, Simonsen EB (2011) Different knee joint loading patterns in ACL deficient copers and non-copers during walking. Knee Surg Sports Traumatol Arthrosc 19(4):615–621
Andriacchi TP, Dyrby CO (2005) Interactions between kinematics and loading during walking for the normal and ACL deficient knee. J Biomech 38(2):293–298
Andriacchi TP, Mundermann A, Smith RL, Alexander EJ, Dyrby CO, Koo S (2004) A framework for the in vivo pathomechanics of osteoarthritis at the knee. Ann Biomed Eng 32(3):447–457
Bach BR Jr, Warren RF, Flynn WM, Kroll M, Wickiewiecz TL (1990) Arthrometric evaluation of knees that have a torn anterior cruciate ligament. J Bone Joint Surg Am 72(9):1299–1306
Butler DL, Noyes FR, Grood ES (1980) Ligamentous restraints to anterior-posterior drawer in the human knee. A biomechanical study. J Bone Joint Surg Am 62-A(2):259–270
Chaudhari AM, Briant PL, Bevill SL, Koo S, Andriacchi TP (2008) Knee kinematics, cartilage morphology, and osteoarthritis after ACL injury. Med Sci Sports Exerc 40(2):215–222
Eastlack ME, Axe MJ, Snyder-Mackler L (1999) Laxity, instability, and functional outcome after ACL injury: copers versus noncopers. Med Sci Sports Exerc 31(2):210–215
Englund M (2010) The role of biomechanics in the initiation and progression of OA of the knee. Best Pract Res Clin Rheumatol 24(1):39–46
Frobell RB, Roos EM, Roos HP, Ranstam J, Lohmander LS (2010) A randomized trial of treatment for acute anterior cruciate ligament tears. N Engl J Med 363(4):331–342
Frobell RB, Roos HP, Roos EM, Roemer FW, Ranstam J, Lohmander LS (2013) Treatment for acute anterior cruciate ligament tear: five year outcome of randomised trial. BMJ 346:f232
Gao B, Zheng NN (2010) Alterations in three-dimensional joint kinematics of anterior cruciate ligament-deficient and -reconstructed knees during walking. Clin Biomech (Bristol, Avon) 25(3):222–229
Georgoulis AD, Ristanis S, Moraiti CO, Paschos N, Zampeli F, Xergia S, Georgiou S, Patras K, Vasiliadis HS, Mitsionis G (2010) ACL injury and reconstruction: clinical related in vivo biomechanics. Orthop Traumatol Surg Res 96(8 Suppl):119–128
Gustavsson A, Neeter C, Thomee P, Silbernagel KG, Augustsson J, Thomee R, Karlsson J (2006) A test battery for evaluating hop performance in patients with an ACL injury and patients who have undergone ACL reconstruction. Knee Surg Sports Traumatol Arthrosc 14(8):778–788
Heijink A, Gomoll AH, Madry H, Drobnic M, Filardo G, Espregueira-Mendes J, Van Dijk CN (2012) Biomechanical considerations in the pathogenesis of osteoarthritis of the knee. Knee Surg Sports Traumatol Arthrosc 20(3):423–435
Hofbauer M, Thorhauer ED, Abebe E, Bey M, Tashman S (2014) Altered tibiofemoral kinematics in the affected knee and compensatory changes in the contralateral knee after anterior cruciate ligament reconstruction. Am J Sports Med 42(11):2715–2721
Hurd WJ, Axe MJ, Snyder-Mackler L (2008) A 10-year prospective trial of a patient management algorithm and screening examination for highly active individuals with anterior cruciate ligament injury: part 2, determinants of dynamic knee stability. Am J Sports Med 36(1):48–56
Kvist J (2004) Sagittal plane translation during level walking in poor-functioning and well-functioning patients with anterior cruciate ligament deficiency. Am J Sports Med 32(5):1250–1255
Kvist J (2005) Sagittal tibial translation during exercises in the anterior cruciate ligament-deficient knee. Scand J Med Sci Sports 15:148–158
Kvist J, Gillquist J (2001) Anterior positioning of tibia during motion after anterior cruciate ligament injury. Med Sci Sports Exerc 33(7):1063–1072
Kvist J, Gillquist J (2001) Sagittal plane knee translation and electromyographic activity during closed and open kinetic chain exercises in anterior cruciate ligament-deficient patients and control subjects. Am J Sports Med 29(1):72–82
Kvist J, Good L, Tagesson S (2007) Changes in knee motion pattern after anterior cruciate ligament injury—case report. Clin Biomech (Bristol, Avon) 22(5):551–556
Lohmander LS, Ostenberg A, Englund M, Roos H (2004) High prevalence of knee osteoarthritis, pain, and functional limitations in female soccer players twelve years after anterior cruciate ligament injury. Arthritis Rheum 50(10):3145–3152
Lohmander LS, Englund PM, Dahl LL, Roos EM (2007) The long-term consequence of anterior cruciate ligament and meniscus injuries: osteoarthritis. Am J Sports Med 35(10):1756–1769
Louboutin H, Debarge R, Richou J, Selmi TA, Donell ST, Neyret P, Dubrana F (2009) Osteoarthritis in patients with anterior cruciate ligament rupture: a review of risk factors. Knee 16(4):239–244
Mc Leod WD (1985) The biomechanics and function of the secondary restraints to the anterior cruciate liagment. Orthop Clin North Am 16(2):165–170
Meuffels DE, Favejee MM, Vissers MM, Heijboer MP, Reijman M, Verhaar JA (2009) Ten year follow-up study comparing conservative versus operative treatment of anterior cruciate ligament ruptures. A matched-pair analysis of high level athletes. Br J Sports Med 43(5):347–351
Mohtadi N (1998) Development and validation of the quality of life outcome measure (questionnaire) for chronic anterior cruciate ligament deficiency. Am J Sports Med 26(3):350–359
Moksnes H, Risberg MA (2009) Performance-based functional evaluation of non-operative and operative treatment after anterior cruciate ligament injury. Scand J Med Sci Sports 19(3):345–355
Palmieri-Smith RM, Thomas AC (2009) A neuromuscular mechanism of posttraumatic osteoarthritis associated with ACL injury. Exerc Sport Sci Rev 37(3):147–153
Patel RR, Hurwitz DE, Bush-Joseph CA, Bach BR Jr, Andriacchi TP (2003) Comparison of clinical and dynamic knee function in patients with anterior cruciate ligament deficiency. Am J Sports Med 31(1):68–74
Riordan EA, Frobell RB, Roemer FW, Hunter DJ (2013) The health and structural consequences of acute knee injuries involving rupture of the anterior cruciate ligament. Rheum Dis Clin North Am 39(1):107–122
Roos EM, Roos HP, Lohmander LS, Ekdahl C, Beynnon BD (1998) Knee Injury and Osteoarthritis Outcome Score (KOOS)–development of a self-administered outcome measure. J Orthop Sports Phys Ther 28(2):88–96
Rudolph KS, Eastlack ME, Axe MJ, Snyder-Mackler L (1998) 1998 Basmajian Student Award Paper: Movement patterns after anterior cruciate ligament injury: a comparison of patients who compensate well for the injury and those who require operative stabilization. J Electromyogr Kinesiol 8(6):349–362
Snyder-Mackler L, Fitzgerald GK, Bartolozzi AR 3rd, Ciccotti MG (1997) The relationship between passive joint laxity and functional outcome after anterior cruciate ligament injury. Am J Sports Med 25(2):191–195
Tagesson S, Oberg B, Good L, Kvist J (2008) A comprehensive rehabilitation program with quadriceps strengthening in closed versus open kinetic chain exercise in patients with anterior cruciate ligament deficiency: a randomized clinical trial evaluating dynamic tibial translation and muscle function. Am J Sports Med 36(2):298–307
Tagesson S, Oberg B, Kvist J (2010) Tibial translation and muscle activation during rehabilitation exercises 5 weeks after anterior cruciate ligament reconstruction. Scand J Med Sci Sports 20(1):154–164
Tagesson S, Oberg B, Kvist J (2014) Static and dynamic tibial translation before, 5 weeks after, and 5 years after anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc. doi:10.1007/s00167-014-3279-8
Tegner Y, Lysholm J (1985) Rating systems in the evaluation of knee ligament injuries. Clin Orthop Relat Res 198:43–49
Vergis A (1999) Sagittal plane knee translation in healthy and ACL deficient subjects. A methodological study in vivo with clinical implications. Linköpings Universitet, Linköping
Vergis A, Hindriks M, Gillquist J (1997) Sagittal plane translations of the knee in anterior cruciate deficient subjects and controls. Med Sci Sports Exerc 29(12):1561–1566
Vergis A, Hammerby S, Gillquist J (2002) Fluoroscopic validation of electrogoniometrically measured femorotibial translation in healthy and ACL deficient subjects. Scand J Med Sci Sports 12(4):223–229
von Porat A, Henriksson M, Holmstrom E, Roos EM (2007) Knee kinematics and kinetics in former soccer players with a 16-year-old ACL injury—the effects of twelve weeks of knee-specific training. BMC Musculoskelet Disord 8:35
Williams GN, Chmielewski T, Rudolph K, Buchanan TS, Snyder-Mackler L (2001) Dynamic knee stability: current theory and implications for clinicians and scientists. J Orthop Sports Phys Ther 31(10):546–566
The authors thank the Orthopedic Department at the University Hospital, Linköping, for cooperation, physiotherapists Eleonore Rapp and Daniel Urberg for assistance in data collection, and Dr. Clare Ardern, School of Allied Health, La Trobe University, Melbourne, Australia, and Division of Physiotherapy, Linköping University, Linköping, Sweden, for valuable comments on the manuscript. This study was supported by the Faculty of Health Sciences at Linköping University and by grants from the Swedish Centre for Research in Sports.
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The authors declare that they do not have any financial or personal relationships with other people or organizations that could inappropriate influence (bias) this work.
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Sonesson, S., Kvist, J. Dynamic and static tibial translation in patients with anterior cruciate ligament deficiency initially treated with a structured rehabilitation protocol. Knee Surg Sports Traumatol Arthrosc 25, 2337–2346 (2017). https://doi.org/10.1007/s00167-015-3714-5