Bilateral accommodations to anterior cruciate ligament deficiency and surgery

Objective. To determine bilateral lower extremity joint accommodations during gait in anterior cruciate ligament deficient subjects and uninjured controls. Design. Gait testing of 10 chronic anterior cruciate ligament deficient subjects prior to and 3 months following reconstructive surgery, and 10 uninjured controls. Background. It is possible that bilateral joint accommodations could occur as a result of anterior cruciate ligament injury and in response to surgical repair. Few studies have investigated bilateral joint accommodations to anterior cruciate ligament injury and there is little consistency in the reported results. Methods. Bilateral lower extremity kinematic and kinetic data were collected from 12 walking trials and inverse dynamics calculations were made to estimate bilateral knee and hip joint angle, moment, and power patterns during the stance phase of gait. Results. Control subjects exhibited asymmetrical hip but symmetrical knee joint moment and power patterns. In contrast, the anterior cruciate ligament deficient subjects exhibited symmetrical hip and asymmetrical knee joint moment and power patterns prior to and following reconstructive surgery. Conclusions. Gait asymmetry in healthy subjects should not be considered pathological. In addition, chronic anterior cruciate ligament injury results in joint specific, bilateral lower extremity accommodations in gait mechanics. These accommodations persist 3 months following surgical repair.