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Compensatory mechanisms in anterior cruciate ligament deficiency

  • Knee
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

The literature cites numerous studies involving the analysis of movement patterns in anterior cruciate ligament deficient (ACLD) patients. Although several in vivo biomechanical studies have shown that ACLD patients develop protective mechanisms against degenerative diseases, it seems that these adaptations fail to protect the knee from future pathology. Some authors state that ACLD patients adapt to the injury by avoiding quadriceps contraction during gait when the knee is near full extension. However, others have found increased hamstrings and decreased gastrocnemius activity, which normally contribute to the stability of the knee. It seems that further in vivo biomechanical investigation is required to understand the mechanisms of pathological knee joint motions and develop rehabilitation programs, which would delay the progress of developing long-term degenerative diseases.

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References

  1. Andersen HN, Amis AA (1994) Review on tension in the natural and reconstructed anterior cruciate ligament. Knee Surg Sports Traumatol Arthrosc 2:192–202

    CAS  PubMed  Google Scholar 

  2. Andriacchi TP (1990) Dynamics of pathological motion: applied to the anterior cruciate deficient knee. J Biomech 23 Suppl 1:99–105

    Google Scholar 

  3. Andriacchi TP, Alexander EJ (2000) Studies of human locomotion: past, present and future. J Biomech 33:1217–1224

    Article  CAS  PubMed  Google Scholar 

  4. Andriacchi TP, Birac D (1993) Functional testing in the anterior cruciate ligament-deficient knee. Clin Orthop 288:40–47

    PubMed  Google Scholar 

  5. Andriacchi TP, Alexander EJ, Toney MK, Dyrby C, Sum J (1998) A point cluster method for in vivo motion analysis: applied to a study of knee kinematics. J Biomech Eng 120:743–749

    CAS  PubMed  Google Scholar 

  6. Andriacchi TP, Dyrby CO, Dillingham MF (2001) Dynamic rotational offset of the anterior cruciate deficient knee during walking. In: Woo SL-Y, Abramovitz SD, Tsuda E (eds) Proceedings of the 2nd International Symposium on Ligaments and Tendons. Stanford University, pp 19

  7. Arms SW, Pope MH, Johnson RJ, Fischer RA, Arvidsson I, Eriksson E (1984) The biomechanics of anterior cruciate ligament rehabilitation and reconstruction. Am J Sports Med 12:8–18

    CAS  PubMed  Google Scholar 

  8. Beard DJ, Soundarapandian RS, O'Connor JJ, Dodd CAF (1996) Gait and electromyographic analysis of anterior cruciate ligament deficient subjects. Gait Posture 4:83–88

    Article  Google Scholar 

  9. Berchuck M, Andriacchi TP, Bach BR, Reider B (1990) Gait adaptations by patients who have a deficient anterior cruciate ligament. J Bone Joint Surg Am 72:871–877

    CAS  PubMed  Google Scholar 

  10. Beynnon BD, Fleming BC (1998) Anterior cruciate ligament strain in vivo: a review of previous work. J Biomech 31:519–525

    PubMed  Google Scholar 

  11. Bush-Joseph CA, Hurwitz DE, Patel RR, Bahrani Y, Garretson R, Bach BR Jr, Andriacchi TP (2001) Dynamic function after anterior cruciate ligament reconstruction with autologous patellar tendon. Am J Sports Med 29:36–41

    CAS  Google Scholar 

  12. Cappozzo A, Catani F, Leardini A, Benedetti MG, Della CU (1996) Position and orientation in space of bones during movement: experimental artifacts. Clin Biomech 11:90–100

    Article  Google Scholar 

  13. Chèze L, Fregly BJ, Dimnet J (1995) A solidification procedure to facilitate kinematic analyses based on video system data. J Biomech 28:879–884

    Article  CAS  PubMed  Google Scholar 

  14. Ciccotti MG, Kerlan RK, Perry J, Pink M (1994) An electromyographic analysis of the knee during functional activities. II. The anterior cruciate ligament-deficient and -reconstructed profiles. Am J Sports Med 22:651–658

    PubMed  Google Scholar 

  15. Czerniecki JM, Lippert F, Olerud JE (1988) A biomechanical evaluation of tibiofemoral rotation in anterior cruciate deficient knees during walking and running. Am J Sports Med 16:327–331

    PubMed  Google Scholar 

  16. Daniel DM, Stone ML, Dobson BE, Fithian DC, Rossman DJ, Kaufman KR (1994) Fate of the ACL-injured patient. A prospective outcome study. Am J Sports Med 22:632–644

    CAS  PubMed  Google Scholar 

  17. Devita P, Hortobagyi T, Barrier J, Torry M, Glover KL, Speroni DL, Money J, Mahar MT (1997) Gait adaptations before and after anterior cruciate ligament reconstruction surgery. Med Sci Sports Exerc 29:853–859

    CAS  PubMed  Google Scholar 

  18. Devita P, Hortobagyi T, Barrier J (1998) Gait biomechanics are not normal after anterior cruciate ligament reconstruction and accelerated rehabilitation. Med Sci Sports Exerc 30:1481–1488

    CAS  PubMed  Google Scholar 

  19. Fleming BC, Renstroem P, Ohlen G, Beynnon BD (2001) The gastrocnemius is an antagonist of the anterior cruciate ligament. Arthroscopy 17:S43

    Google Scholar 

  20. Griffin LY, Agel J, Albohm MJ, Arendt EA, Dick RW, Garrett WE, Garrick JG, Hewett TE, Huston L, Ireland ML, Johnson RJ, Kibler WB, Lephart S, Lewis JL, Lindenfeld TN, Mandelbaum BR, Marchak P, Teitz CC, Wojtys EM (2000) Noncontact anterior cruciate ligament injuries: risk factors and prevention strategies. J Am Acad Orthop Surg 8:141–150

    CAS  PubMed  Google Scholar 

  21. Halvorsen K, Lesser M, Lundberg A (1999) A new method for estimating the axis of rotation and the center of rotation. J Biomech 32:1221–1227

    Article  CAS  PubMed  Google Scholar 

  22. Hill PF, Vedi V, Williams A, Iwaki H, Pinskerova V, Freeman MA (2000) Tibiofemoral movement 2: the loaded and unloaded living knee studied by MRI. J Bone Joint Surg Br 82:1196–1198

    Article  CAS  PubMed  Google Scholar 

  23. Iwaki H, Pinskerova V, Freeman MA (2000) Tibiofemoral movement 1: the shapes and relative movements of the femur and tibia in the unloaded cadaver knee. J Bone Joint Surg Br 82:1189–1195

    Article  CAS  PubMed  Google Scholar 

  24. Jonsson H, Karrholm J, Elmqvist LG (1989) Kinematics of active knee extension after tear of the anterior cruciate ligament. Am J Sports Med 17:796–802

    CAS  PubMed  Google Scholar 

  25. Karrholm J, Selvik G, Elmqvist LG, Hansson LI, Jonsson H (1988) Three-dimensional instability of the anterior cruciate deficient knee. J Bone Joint Surg Br 70:777–783

    CAS  PubMed  Google Scholar 

  26. Karrholm J, Brandsson S, Freeman MA (2000) Tibiofemoral movement 4: changes of axial tibial rotation caused by forced rotation at the weight-bearing knee studied by RSA. J Bone Joint Surg Br 82:1201–1203

    Article  CAS  PubMed  Google Scholar 

  27. Kitazaki S, Griffin MJ (1995) A data correction method for surface measurement of vibration on the human body. J Biomech 28:885–890

    Article  CAS  PubMed  Google Scholar 

  28. Kvist J, Karlberg C, Gerdle B, Gillquist J (2001) Anterior tibial translation during different isokinetic quadriceps torque in anterior cruciate ligament deficient and nonimpaired individuals. J Orthop Sports Phys Ther 31:4–15

    CAS  PubMed  Google Scholar 

  29. Lafortune MA (1991) Three-dimensional acceleration of the tibia during walking and running. J Biomech 24:877–886

    PubMed  Google Scholar 

  30. Lafortune MA, Cavanagh PR, Sommer HJ, III, Kalenak A (1992) Three-dimensional kinematics of the human knee during walking. J Biomech 25:347–357

    CAS  PubMed  Google Scholar 

  31. Lass P, Kaalund S, leFevre S, Arendt-Nielsen L, Sinkjaer T, Simonsen O (1991) Muscle coordination following rupture of the anterior cruciate ligament. Electromyographic studies of 14 patients. Acta Orthop Scand 62:9–14

    CAS  PubMed  Google Scholar 

  32. Lent ME van, Drost MR, vd Wildenberg FA (1994) EMG profiles of ACL-deficient patients during walking: the influence of mild fatigue. Int J Sports Med 15:508–514

    PubMed  Google Scholar 

  33. Limbird TJ, Shiavi R, Frazer M, Borra H (1988) EMG profiles of knee joint musculature during walking: changes induced by anterior cruciate ligament deficiency. J Orthop Res 6:630–638

    PubMed  Google Scholar 

  34. Liu W, Maitland ME (2000) The effect of hamstring muscle compensation for anterior laxity in the ACL-deficient knee during gait. J Biomech 33:871–879

    Article  CAS  PubMed  Google Scholar 

  35. Lucchetti L, Cappozzo A, Cappello A, Della CU (1998) Skin movement artefact assessment and compensation in the estimation of knee-joint kinematics. J Biomech 31:977–984

    Article  CAS  PubMed  Google Scholar 

  36. McGinty G, Irrgang JJ, Pezzullo D (2000) Biomechanical considerations for rehabilitation of the knee. Clin Biomech 15:160–166

    Article  CAS  Google Scholar 

  37. McLean SG, Myers PT, Neal RJ, Walters MR (1998) A quantitative analysis of knee joint kinematics during the sidestep cutting maneuver. Implications for non-contact anterior cruciate ligament injury. Bull Hosp Joint Dis 57:30–38

    CAS  Google Scholar 

  38. Nakagawa S, Kadoya Y, Todo S, Kobayashi A, Sakamoto H, Freeman MA, Yamano Y (2000) Tibiofemoral movement 3: full flexion in the living knee studied by MRI. J Bone Joint Surg Br 82:1199–1200

    Article  CAS  PubMed  Google Scholar 

  39. Noyes FR, Grood ES (1998) Diagnosis of Knee Ligament Injuries: clinical Concepts. In: John A, Feagin JR (ed) The crucial ligaments: diagnosis and treatment of ligamentous injuries about the knee. Churchill Livingstone, New York, pp 261–285

    Google Scholar 

  40. Noyes FR, Mooar PA, Matthews DS, Butler DL (1983) The symptomatic anterior cruciate-deficient knee. I. the long-term functional disability in athletically active individuals. J Bone Joint Surg Am 65:154–162

    CAS  PubMed  Google Scholar 

  41. Noyes FR, Schipplein OD, Andriacchi TP, Saddemi SR, Weise M (1992) The anterior cruciate ligament-deficient knee with varus alignment. An analysis of gait adaptations and dynamic joint loadings. Am J Sports Med 20:707–716

    CAS  PubMed  Google Scholar 

  42. Papadonikolakis A, Georgoulis AD, Papageorgiou CD, Moebius UG (2001) Kinematic patterns before and after ACL reconstruction. Arthroscopy 17:S45

    Google Scholar 

  43. Patel RR, Hurwitz D, Andriacchi TP, Bush-Joseph C, Bach B (1996) Mechanisms by which patients with anterior cruciate ligament deficiency generate the 'quadriceps avoidance gait'. In: Proceedings of the 21st Annual Meeting of the American Society of Biomechanics, pp 210–211

  44. Patel RR, Hurwitz DE, Andriacchi TP, Bush-Joseph C, Bach BR (1996) Mechanisms for the 'quadriceps avoidance gait' seen in ACL deficient patients. Gait Posture 5:147

    Article  Google Scholar 

  45. Pinskerova V, Maquet P, Freeman MA (2000) Writings on the knee between 1836 and 1917. J Bone Joint Surg Br 82:1100–1102

    Article  CAS  PubMed  Google Scholar 

  46. Ramsey DK, Wretenberg PF (1999) Biomechanics of the knee: methodological considerations in the in vivo kinematic analysis of the tibiofemoral and patellofemoral joint. Clin Biomech 14:595–611

    Article  CAS  Google Scholar 

  47. Ramsey DK, Lamontagne M, Wretenberg PF, Valentin A, Engstrom B, Nemeth G (2001) Assessment of functional knee bracing: an in vivo three-dimensional kinematic analysis of the anterior cruciate deficient knee. Clin Biomech 16:61–70

    Article  CAS  Google Scholar 

  48. Roberts CS, Rash GS, Honaker JT, Wachowiak MP, Shaw JC (1999) A deficient anterior cruciate ligament does not lead to quadriceps avoidance gait. Gait Posture 10:189–199

    Article  CAS  PubMed  Google Scholar 

  49. Tibone JE, Antich TJ, Fanton GS, Moynes DR, Perry J (1986) Functional analysis of anterior cruciate ligament instability. Am J Sports Med 14:276–284

    Google Scholar 

  50. Timoney JM, Inman WS, Quesada PM, Sharkey PF, Barrack RL, Skinner HB, Alexander AH (1993) Return of normal gait patterns after anterior cruciate ligament reconstruction. Am J Sports Med 21:887–889

    CAS  PubMed  Google Scholar 

  51. Torry MR, Decker MJ, Viola RW, O'Connor DD, Steadman JR (2000) Intra-articular knee joint effusion induces quadriceps avoidance gait patterns. Clin Biomech 15:147–159

    Article  CAS  Google Scholar 

  52. Wexler G, Hurwitz DE, Bush-Joseph CA, Andriacchi TP, Bach BR Jr (1998) Functional gait adaptations in patients with anterior cruciate ligament deficiency over time. Clin Orthop 348:166–175

    PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, School of Medicine, University of Ioannina, 45110, Ioannina, Greece

    Anastasios Papadonikolakis, Anastasios D. Georgoulis & Panayotis N. Soucacos

  2. Tiveriou 7, 13121, Ilion Athens, Greece

    Anastasios Papadonikolakis

  3. HPER Biomechanics Lab, University of Nebraska at Omaha, Omaha, Neb., USA

    Lance Cooper & Nicholas Stergiou

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  1. Anastasios Papadonikolakis
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  2. Lance Cooper
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Correspondence to Anastasios Papadonikolakis.

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Papadonikolakis, A., Cooper, L., Stergiou, N. et al. Compensatory mechanisms in anterior cruciate ligament deficiency. Knee Surg Sports Traumatol Arthrosc 11, 235–243 (2003). https://doi.org/10.1007/s00167-003-0367-6

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  • DOI: https://doi.org/10.1007/s00167-003-0367-6

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