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Gender differences in the restoration of knee joint biomechanics during gait after anterior cruciate ligament reconstruction
Authors:Makoto Asaeda  Masataka Deie  Naoto Fujita  Yoshifumi Kono  Chiaki Terai  Wataru Kuwahara  Hodaka Watanabe  Hiroaki Kimura  Nobuo Adachi  Toru Sunagawa  Mitsuo Ochi
Affiliation:1. Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan;2. Department of Orthopedic surgery, Aichi Medical University, 1-1 Yazakokarimata, Nagakute, Aichi 480-1195, Japan;3. Integrated Health Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan;4. Division of Rehabilitation, Department of Clinical Practice and Support, Hiroshima University Hospital, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan;5. Department of Rehabilitation, Nagoya University Hospital, 65 Tsuruma-cho, Showa-Ku, Nagoya, Aichi 466-8550, Japan;6. Department of Rehabilitation, Hiroshima University Hospital, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan;7. Department of Orthopaedic Surgery, Integrated Health Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan
Abstract:

Background

The aim of our study was to evaluate the effects of gender on recovery of knee joint biomechanics over the stance phase of gait after reconstruction of the anterior cruciate ligament (ACL).

Methods

Gait parameters and knee joint kinematics and kinetics were compared in 32 patients (16 male and 16 female) who underwent ACL reconstruction for a unilateral ACL deficiency, with comparison to an age-, height-, and weight-matched Control group. Knee flexion, adduction and tibial rotation angles were measured and knee extension and abduction moment was calculated by inverse dynamics methods.

Results

Females exhibited more tibial external rotation, in both the Control and ACL groups (P < 0.05), which was not changed after ACL reconstruction. Prior to reconstruction, sagittal plane biomechanics were changed, in both males and females, compared to the Control groups (P < 0.05). These abnormal sagittal plane mechanics were recovered at 12 months, but not six months post-reconstruction.

Conclusions

We identified gender-based differences in tibial rotation that influenced the kinematics and kinetics of the knee over the stance phase of gait, both pre-operatively and post-ACL reconstruction. Evaluation of biomechanical effects of ACL injury, before and after reconstruction, should be separately evaluated for females and males.
Keywords:Anterior cruciate ligament injury  Anterior cruciate ligament reconstruction  Gait analysis  Knee biomechanics  Gender differences
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