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Changes in gait patterns after anterior cruciate ligament reconstruction in children

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Abstract

Purpose

Anterior cruciate ligament reconstruction (ACLR) in children is indicated to reduce recurrent knee instability and further damage to the joint. Postoperative modified gait pattern was reported in the adult population after ACLR. The aim of this study was to analyse gait abnormalities, and especially knee and ankle adaptations during gait in children after ACLR.

Methods

A prospective study was performed between 2018 and 2022 on 50 children, aged nine to 15 years with unilateral ACL deficiency. Changes in gait pattern were evaluated by gait analysis before surgery and at the latest follow-up of 24 months. Kinematic data of ACL-deficient limb were compared to contralateral limb and to those of a matched control group of healthy children.

Results

Compared to control group, knee flexion was decreased for both ACL-deficient and contralateral knee before surgery. Decreased knee flexion during gait cycle persisted at latest follow-up. Ankle kinematics showed decreased dorsal flexion for both ACL-deficient and contralateral limb before surgery. At latest follow-up, ankle kinematics were modified for ACL-reconstructed limbs only at initial contact and showed no significant difference for contralateral limb compared to the control group.

Conclusion

In children with ACL injury, abnormal gait patterns persist two years after ligament reconstruction, in spite of extensive rehabilitation and no clinical complaints. These findings might guide neuromuscular training to improve clinical outcomes and reduce the rerupture rate.

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Funding

This study was supported by Zimmer Biomet.

Author information

Authors and Affiliations

  1. Orthopédie Traumatologie, Hôpital Des Enfants, CHU de Toulouse, Avenue de Grande Bretagne, 31059, Toulouse Cedex 9, France

    Monica Urseï, Marino Scandella, Jérôme Sales de Gauzy & Franck Accadbled

  2. Institut de Mécanique Des Fluides de Toulouse, IMFT, Université de Toulouse, CNRS, 31000, Toulouse, France

    Jérôme Briot & Franck Accadbled

  3. Sport Pro Santé Research, 8 Rue Des Braves, 31300, Toulouse, France

    Franck Accadbled

Authors
  1. Monica Urseï
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  2. Jérôme Briot
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  3. Marino Scandella
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  4. Jérôme Sales de Gauzy
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  5. Franck Accadbled
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Corresponding author

Correspondence to Franck Accadbled.

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Ethical approval

Ethical approval was obtained from our local Institutional Review Board (RnIPH 2019–56).

Informed consent

Informed written informed consent was obtained from the parents of all patients included in the research.

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All authors consented to the submission of this manuscript.

Conflict of interest

Franck Accadbled has received speaker and consultant honoraria from Orthofix and Zimmer Biomet.

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Urseï, M., Briot, J., Scandella, M. et al. Changes in gait patterns after anterior cruciate ligament reconstruction in children. International Orthopaedics (SICOT) 48, 1517–1523 (2024). https://doi.org/10.1007/s00264-024-06108-5

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  • DOI: https://doi.org/10.1007/s00264-024-06108-5

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