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Movement Patterns of the Knee During Gait Following ACL Reconstruction: A Systematic Review and Meta-Analysis

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Abstract

Background

Altered gait patterns follow ing anterior cruciate ligament reconstruction (ACLR) may be associated with long-term impairments and post-traumatic osteoarthritis.

Objective

This systematic review and meta-analysis compared lower limb kinematics and kinetics of the ACL reconstructed knee with (1) the contralateral limb and (2) healthy age-matched participants during walking, stair climbing, and running. The secondary aim was to describe the differences over time following ACLR for these biomechanical variables.

Method

Database searches were conducted from inception to July 2014 and updated in August 2015 for studies exploring peak knee angles and moments following ACLR during walking, stair negotiation, and running. Risk of bias was assessed with a modified Downs and Black quality index for all included studies, and meta-analyses were performed. Forest plots were explored qualitatively for recovery of gait variables over time after surgery.

Results

A total of 40 studies were included in the review; 26 of these were rated as low risk and 14 as high risk of bias. The meta-analysis included 27 studies. Strong to moderate evidence indicated no significant difference in peak flexion angles between ACLR and control groups during walking and stair ascent. Strong evidence was found for lower peak flexion moments in participants with ACLR compared with control groups and contralateral limb during walking and stair activities. Strong to moderate evidence was found for lower peak adduction moment in ACLR participants for the injured compared with the contralateral limbs during walking and stair descent. The qualitative assessment for recovery over time indicated a pattern towards restoration of peak knee flexion angle with increasing time from post-surgery. Peak knee adduction moments were lower within the first year following surgery and higher than controls during later phases (5 years).

Conclusion

Joint kinematics are restored, on average, 6 years following reconstruction, while knee external flexion moments remain lower than controls. Knee adduction moments are lower during early phases following reconstruction, but are higher than controls, on average, 5 years post-surgery. Findings indicate that knee function is not fully restored following reconstruction, and long-term maintenance programs may be needed.

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References

  1. Thing LF. “Voices of the broken body”. The resumption of non-professional female players’ sports careers after anterior cruciate ligament injury. The female player’s dilemma: is she willing to run the risk? Scand J Med Sci Sports. 2006;16(5):364–75.

    Article  CAS  PubMed  Google Scholar 

  2. Gianotti SM, Marshall SW, Hume PA, et al. Incidence of anterior cruciate ligament injury and other knee ligament injuries: a national population-based study. J Sci Med Sport. 2009;12(6):622–7.

    Article  PubMed  Google Scholar 

  3. Bjordal JM, Arnøy F, Hannestad B, et al. Epidemiology of anterior cruciate ligament injuries in soccer. Am J Sports Med. 1997;25(3):341–5.

    Article  CAS  PubMed  Google Scholar 

  4. Beynnon BD, Johnson RJ, Abate JA, et al. Treatment of anterior cruciate ligament injuries, part I. Am J Sports Med. 2005;33(10):1579–602.

    Article  PubMed  Google Scholar 

  5. Collins JE, Katz JN, Donnell-Fink LA, et al. Cumulative incidence of ACL reconstruction after ACL injury in adults: role of age, sex, and race. Am J Sports Med. 2013;41(3):544–9.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Ardern CL, Taylor NF, Feller JA, et al. Fifty-five per cent return to competitive sport following anterior cruciate ligament reconstruction surgery: an updated systematic review and meta-analysis including aspects of physical functioning and contextual factors. Br J Sports Med. 2014;48(21):1543–52.

    Article  PubMed  Google Scholar 

  7. Lohmander LS, Englund PM, Dahl LL, et al. The long-term consequence of anterior cruciate ligament and meniscus injuries: osteoarthritis. Am J Sports Med. 2007;35(10):1756–69.

    Article  PubMed  Google Scholar 

  8. Smith T, Postle K, Penny F, et al. Is reconstruction the best management strategy for anterior cruciate ligament rupture? A systematic review and meta-analysis comparing anterior cruciate ligament reconstruction versus non-operative treatment. Knee. 2014;21(2):462–70.

    Article  CAS  PubMed  Google Scholar 

  9. Oiestad BE, Holm I, Aune AK, et al. Knee function and prevalence of knee osteoarthritis after anterior cruciate ligament reconstruction: a prospective study with 10 to 15 years of follow-up. Am J Sports Med. 2010;38(11):2201–10.

    Article  PubMed  Google Scholar 

  10. Keays SL, Newcombe PA, Bullock-Saxton JE, et al. Factors involved in the development of osteoarthritis after anterior cruciate ligament surgery. Am J Sports Med. 2010;38(3):455–63.

    Article  PubMed  Google Scholar 

  11. Nigg BM, MacIntosh BR, Mester J, et al. Biomechanics and biology of movement. 1st ed. Champaign: Human Kinetics; 2000.

    Google Scholar 

  12. Foroughi N, Smith R, Vanwanseele B, et al. The association of external knee adduction moment with biomechanical variables in osteoarthritis: a systematic review. Knee. 2009;16(5):303–9.

    Article  PubMed  Google Scholar 

  13. Hart HF, Culvenor AG, Collins NJ, et al. Knee kinematics and joint moments during gait following anterior cruciate ligament reconstruction: a systematic review and meta-analysis. Br J Sports Med. 2015. doi:10.1136/bjsports-2015-094797.

  14. Schipplein O, Andriacchi T. Interaction between active and passive knee stabilizers during level walking. J Orthop Res. 1991;9(1):113–9.

    Article  CAS  PubMed  Google Scholar 

  15. Miyazaki T, Wada M, Kawahara H, et al. Dynamic load at baseline can predict radiographic disease progression in medial compartment knee osteoarthritis. Ann Rheum Dis. 2002;61(7):617–22.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  16. Sharma L, Hurwitz DE, Eugene JAT, et al. Knee adduction moment, serum hyaluronan level, and disease severity in medial tibiofemoral osteoarthritis. Arthritis Rheumatol. 1998;6(9):1233–40.

    Article  Google Scholar 

  17. Webster KE, Feller JA. The knee adduction moment in hamstring and patellar tendon anterior cruciate ligament reconstructed knees. Knee Surg Sports Traumatol Arthrosc. 2012;20(11):2214–9.

    Article  PubMed  Google Scholar 

  18. Patterson MR, Delahunt E, Caulfield B, et al. Peak knee adduction moment during gait in anterior cruciate ligament reconstructed females. Clin Biomech. 2014;29(2):138–42.

    Article  Google Scholar 

  19. Timoney JM, Inman WS, Quesada PM, et al. Return of normal gait patterns after anterior cruciate ligament reconstruction. Am J Sports Med. 1993;21(6):887–9.

    Article  CAS  PubMed  Google Scholar 

  20. Bulgheroni P, Bulgheroni MV, Andrini L, et al. Gait patterns after anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc. 1997;5(1):14–21.

    Article  CAS  PubMed  Google Scholar 

  21. Sosdian L, Dobson F, Wrigley T, et al. Longitudinal changes in knee kinematics and moments following knee arthroplasty: a systematic review. Knee. 2014;21(6):994–1008.

    Article  CAS  PubMed  Google Scholar 

  22. Schmitt LC, Paterno MV, Ford KR, et al. Strength asymmetry and landing mechanics at return to sport after anterior cruciate ligament reconstruction. Med Sci Sports Exerc. 2015;47(7):1426–34.

    Article  PubMed  PubMed Central  Google Scholar 

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

    Article  PubMed  Google Scholar 

  24. Gokeler A, Benjaminse A, Van Eck CF, et al. Return of normal gait as an outcome measurement in ACL reconstructed patients. A systematic review. Int J Sports Phys Ther. 2013;8(4):441–51.

    CAS  PubMed  PubMed Central  Google Scholar 

  25. Hart JM, Ko WK, Konold T, et al. Sagittal plane knee joint moments following anterior cruciate ligament injury and reconstruction: a systematic review. Clin Biomech. 2010;25(4):277–83.

    Article  Google Scholar 

  26. Kutzner I, Heinlein B, Graichen F, et al. Loading of the knee joint during activities of daily living measured in vivo in five subjects. J Biomech. 2010;43(11):2164–73.

    Article  CAS  PubMed  Google Scholar 

  27. Moher D, Liberati A, Tetzlaff J, et al. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Ann Intern Med. 2009;151(4):264–9.

    Article  PubMed  Google Scholar 

  28. Downs SH, Black N. The feasibility of creating a checklist for the assessment of the methodological quality both of randomised and non-randomised studies of health care interventions. J Epidemiol Community Health. 1998;52(6):377–84.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  29. Mündermann A, Dyrby CO, Hurwitz DE, et al. Potential strategies to reduce medial compartment loading in patients with knee osteoarthritis of varying severity: reduced walking speed. Arthritis Rheum. 2004;50(4):1172–8.

    Article  PubMed  Google Scholar 

  30. Barton CJ, Lack S, Malliaras P, et al. Gluteal muscle activity and patellofemoral pain syndrome: a systematic review. Br J Sports Med. 2013;47(4):207–14.

    Article  PubMed  Google Scholar 

  31. Cohen J. Statistical power analysis for behavioural sciences. Hillsdale: Lawrence Eribaum Associates. Inc.:[sn]; 1988.

    Google Scholar 

  32. Van Tulder M, Furlan A, Bombardier B, et al. Updated method guidelines for systematic reviews in the Cochrane Collaboration Back Review Group. Spine. 2003;28(12):1290–9.

    PubMed  Google Scholar 

  33. Schmalz T, Blumentritt S, Wagner R, et al. Gait analysis of patients within one year after ACL reconstruction. Phys Med Rehab Kuror. 1998;8(1):1–8.

    Article  Google Scholar 

  34. Schmalz T, Blumentritt S, Wagner R, et al. Evaluation with biomechanical gait analysis of various treatment methods after rupture of the anterior cruciate ligament. Sportverletzung Sports. 1998;12(4):131–7 (German).

    Article  CAS  Google Scholar 

  35. Wang WM, Zhao DW, Cui DP, et al. Gait analysis associated with anterior cruciate ligament reconstruction. Zhonghua yi Xue Za Zhi. 2009;89(29):2025–9 (Chinese).

    PubMed  Google Scholar 

  36. Scanlan SF, Chaudhari AM, Dyrby CO, et al. Differences in tibial rotation during walking in ACL reconstructed and healthy contralateral knees. J Biomech. 2010;43(9):1817–22.

    Article  PubMed  PubMed Central  Google Scholar 

  37. Gao B, Zheng NN. Alterations in three-dimensional joint kinematics of anterior cruciate ligament-deficient and -reconstructed knees during walking. Clin Biomech. 2010;25(3):222–9.

    Article  Google Scholar 

  38. Varma RK, Duffell LD, Nathwani D, et al. Knee moments of anterior cruciate ligament reconstructed and control participants during normal and inclined walking. BMJ Open. 2014;4(6):004753.

    Article  Google Scholar 

  39. Wang H, Fleischli JE, NigelZheng N. Effect of lower limb dominance on knee joint kinematics after anterior cruciate ligament reconstruction. Clin Biomech. 2012;27(2):170–5.

    Article  Google Scholar 

  40. Butler RJ, Minick KI, Ferber R, et al. Gait mechanics after ACL reconstruction: implications for the early onset of knee osteoarthritis. Br J Sports Med. 2009;43(5):366–70.

    Article  CAS  PubMed  Google Scholar 

  41. Kuenze C, Hertel J, Weltman A, et al. Jogging biomechanics after exercise in individuals with ACL-reconstructed knees. Med Sci Sports Exerc. 2014;46(6):1067–76.

    Article  PubMed  Google Scholar 

  42. Schroeder MJ, Krishnan C, Dhaher YY, et al. The influence of task complexity on knee joint kinetics following ACL reconstruction. Clin Biomech. 2015;30(8):852–9.

    Article  Google Scholar 

  43. Bush-Joseph CA, Hurwitz DE, Patel RR, et al. Dynamic function after anterior cruciate ligament reconstruction with autologous patellar tendon. Am J Sports Med. 2001;29(1):36–41.

    CAS  PubMed  Google Scholar 

  44. Roewer BD, Di Stasi SL, Snyder-Mackler L, et al. Quadriceps strength and weight acceptance strategies continue to improve two years after anterior cruciate ligament reconstruction. J Biomech. 2011;44(10):1948–53.

    Article  PubMed  PubMed Central  Google Scholar 

  45. Di Stasi S, Hartigan EH, Snyder-Mackler L, et al. Sex-specific gait adaptations prior to and up to 6 months after anterior cruciate ligament reconstruction. J Orthop Sports Phys Ther. 2015;45(3):207–14.

    Article  PubMed  PubMed Central  Google Scholar 

  46. Kowalk DL, Duncan JA, McCue FC, et al. Anterior cruciate ligament reconstruction and joint dynamics during stair climbing. Med Sci Sports Exerc. 1997;29(11):1406–13.

    Article  CAS  PubMed  Google Scholar 

  47. Hall M, Stevermer CA, Gillette JC. Gait analysis post anterior cruciate ligament reconstruction: knee osteoarthritis perspective. Gait Posture. 2012;36(1):56–60.

    Article  PubMed  Google Scholar 

  48. Hooper DM, Morrissey MC, Drechsler W, et al. Open and closed kinetic chain exercises in the early period after anterior cruciate ligament reconstruction: improvements in level walking, stair ascent, and stair descent. Am J Sports Med. 2001;29(2):167–74.

    CAS  PubMed  Google Scholar 

  49. Hooper DM, Morrissey MC, Drechsler WI, et al. Gait analysis 6 and 12 months after anterior cruciate ligament reconstruction surgery. Clin Orthop Relat Res. 2002;403:168–78.

    Article  Google Scholar 

  50. Gao B, Cordova ML, Zheng N, et al. Three-dimensional joint kinematics of ACL-deficient and ACL-reconstructed knees during stair ascent and descent. Hum Mov Sci. 2012;31(1):222–35.

    Article  PubMed  Google Scholar 

  51. Zabala MA, Favre J, Scanlan SF, et al. Three-dimensional knee moments of ACL reconstructed and control subjects during gait, stair ascent, and stair descent. J Biomech. 2013;46(3):515–20.

    Article  PubMed  Google Scholar 

  52. Lewek M, Rudolph K, Axe M, et al. The effect of insufficient quadriceps strength on gait after anterior cruciate ligament reconstruction. Clin Biomech (Bristol, Avon). 2002;17(1):56–63.

    Article  PubMed  Google Scholar 

  53. Sato K, Maeda A, Takano Y, et al. Relationship between static anterior laxity using the KT-1000 and dynamic tibial rotation during motion in patients with anatomical anterior cruciate ligament reconstruction. Kurume Med J. 2013;60(1):1–6.

    Article  PubMed  Google Scholar 

  54. Noehren B, Wilson H, Miller C, et al. Long-term gait deviations in anterior cruciate ligament-reconstructed females. Med Sci Sports Exerc. 2013;45(7):1340–7.

    Article  PubMed  PubMed Central  Google Scholar 

  55. Webster KE, Feller FA, Wittwer JE, et al. Longitudinal changes in knee joint biomechanics during level walking following anterior cruciate ligament reconstruction surgery. Gait Posture. 2012;36(2):167–71.

    Article  PubMed  Google Scholar 

  56. EMathZone, CV. Reference for grand mean: EMathZone, Combined variance. Available from: http://www.emathzone.com/tutorials/basic-statistics/combined-variance.html. Accessed 7 Oct 2014.

  57. Webster KE, Wittwer JE, O’Brien J, et al. Gait patterns after anterior cruciate ligament reconstruction are related to graft type. Am J Sports Med. 2005;33(2):247–54.

    Article  PubMed  Google Scholar 

  58. Webster KE, Feller JA. Alterations in joint kinematics during walking following hamstring and patellar tendon anterior cruciate ligament reconstruction surgery. Clin Biomech (Bristol, Avon). 2011;26(2):175–80.

    Article  PubMed  Google Scholar 

  59. Czamara A, Markowska I, Królikowska A, et al. Kinematics of rotation in joints of the lower limbs and pelvis during gait: early results—SB ACLR approach versus DB ACLR approach. Biomed Res Int. 2015. doi:10.1155/2015/707168.

  60. Wang HS, Fleischli JE, Zheng NQ, et al. Transtibial versus anteromedial portal technique in single-bundle anterior cruciate ligament reconstruction outcomes of knee joint kinematics during walking. Am J Sports Med. 2013;41(8):1847–56.

    Article  PubMed  Google Scholar 

  61. Di Stasi SL, Logerstedt D, Gardinier ES, et al. Gait patterns differ between ACL-reconstructed athletes who pass return-to-sport criteria and those who fail. Am J Sports Med. 2013;41(6):1310–8.

    Article  PubMed  PubMed Central  Google Scholar 

  62. Ferber R, Osternig LR, Woollacott MH, et al. Gait mechanics in chronic ACL deficiency and subsequent repair. Clin Biomech. 2002;17(4):274–85.

    Article  Google Scholar 

  63. Georgoulis AD, Papadonikolakis CD, Papageorgiou, et al. Three-dimensional tibiofemoral kinematics of the anterior cruciate ligament-deficient and reconstructed knee during walking. Am J Sports Med. 2003;31(1):75–9.

    PubMed  Google Scholar 

  64. Lafortune M, Cavanagh P, Sommer H, et al. Three-dimensional kinematics of the human knee during walking. J Biomech. 1992;25(4):347–57.

    Article  CAS  PubMed  Google Scholar 

  65. Karimi M, Fatoye F, Mirbod SM, et al. Gait analysis of anterior cruciate ligament reconstructed subjects with a combined tendon obtained from hamstring and peroneus longus. Knee. 2013;20(6):526–31.

    Article  PubMed  Google Scholar 

  66. Di Stasi SL, Snyder-Mackler L. The effects of neuromuscular training on the gait patterns of ACL-deficient men and women. Clin Biomech. 2012;27(4):360–5.

    Article  Google Scholar 

  67. Andriacchi TP, Mündermann A. The role of ambulatory mechanics in the initiation and progression of knee osteoarthritis. Curr Opin Rheumatol. 2006;18(5):514–8.

    Article  PubMed  Google Scholar 

  68. Tashman S, Collon D, Anderson K, et al. Abnormal rotational knee motion during running after anterior cruciate ligament reconstruction. Am J Sports Med. 2004;32(4):975–83.

    Article  PubMed  Google Scholar 

  69. Andriacchi TP, Dyrby CO. Interactions between kinematics and loading during walking for the normal and ACL deficient knee. J Biomech. 2005;38(2):293–8.

    Article  PubMed  Google Scholar 

  70. Nyland J, Klein S, Caborn DN, et al. Lower extremity compensatory neuromuscular and biomechanical adaptations 2 to 11 years after anterior cruciate ligament reconstruction. Arthroscopy. 2010;26(9):1212–25.

    Article  PubMed  Google Scholar 

  71. Kuenze CM, Hertel J, Weltman A, et al. Persistent neuromuscular and corticomotor quadriceps asymmetry after anterior cruciate ligament reconstruction. J Athl Train. 2015;50(3):303–12.

    Article  PubMed  PubMed Central  Google Scholar 

  72. Kartus J, Magnusson L, Stener S, et al. Complications following arthroscopic anterior cruciate ligament reconstruction: a 2- to 5-year follow-up of 604 patients with special emphasis on anterior knee pain. Knee Surg Sports Traumatol Arthrosc. 1999;7(1):2–8.

    Article  CAS  PubMed  Google Scholar 

  73. Hodges PW, Tucker K. Moving differently in pain: a new theory to explain the adaptation to pain. Pain. 2011;152(3):S90–8.

    Article  PubMed  Google Scholar 

  74. Courtney CA, Rine RM. Central somatosensory changes associated with improved dynamic balance in subjects with anterior cruciate ligament deficiency. Gait Posture. 2006;24(2):190–5.

    Article  PubMed  Google Scholar 

  75. Andriacchi TP, Briant PL, Bevill SL, et al. Rotational changes at the knee after ACL injury cause cartilage thinning. Clin Orthop Relat Res. 2006;442:39–44. doi:10.1097/01.blo.0000197079.26600.09.

    Article  PubMed  Google Scholar 

  76. Shelburne KB, Torry MR, Pandy MG. Contributions of muscles, ligaments, and the ground-reaction force to tibiofemoral joint loading during normal gait. J Orthop Res. 2006;24(10):1983–90.

    Article  PubMed  Google Scholar 

  77. Urbach D, Nebelung W, Röpke M, et al. Bilateral dysfunction of the quadriceps muscle after unilateral cruciate ligament rupture with concomitant injury central activation deficit. Unfallchirurg. 2000;103(11):949–55.

    Article  CAS  PubMed  Google Scholar 

  78. Urbach D, Nebelung W, Becker R, et al. Effects of reconstruction of the anterior cruciate ligament on voluntary activation of quadriceps femoris a prospective twitch interpolation study. J Bone Joint Surg Br. 2001;83(8):1104–10.

    Article  CAS  PubMed  Google Scholar 

  79. Barret DS. Proprioception and function after anterior cruciate reconstruction. J Bone Joint Surg Br. 1999;73(5):833–7.

    Google Scholar 

  80. Roos H, Adalberth T, Dahlberg L, et al. Osteoarthritis of the knee after injury to the anterior cruciate ligament or meniscus: the influence of time and age. Osteoarthritis Cartilage. 1995;3(4):261–7.

    Article  CAS  PubMed  Google Scholar 

  81. Roos PJ, Neu CP, Hull ML, et al. A new tibial coordinate system improves the precision of anterior-posterior knee laxity measurements: a cadaveric study using Roentgen stereophotogrammetric analysis. J Orthop Res. 2005;23(2):327–33.

    Article  CAS  PubMed  Google Scholar 

  82. Knoll Z, Kiss RM, Kocsis L, et al. Gait adaptation in ACL deficient patients before and after anterior cruciate ligament reconstruction surgery. J Electromyogr Kinesiol. 2004;14(3):287–94.

    Article  PubMed  Google Scholar 

  83. Setton LA, Elliott DM, Mow VC. Altered mechanics of cartilage with osteoarthritis: human osteoarthritis and an experimental model of joint degeneration. Osteoarthritis Cartilage. 1999;7(1):2–14.

    Article  CAS  PubMed  Google Scholar 

  84. Myer GD, Chu DA, Brent JL, et al. Trunk and hip control neuromuscular training for the prevention of knee joint injury. Clin Sports Med. 2008;27(3):425–48.

    Article  PubMed  PubMed Central  Google Scholar 

  85. Paterno MV, Ford KR, Myer GD, et al. Limb asymmetries in landing and jumping 2 years following anterior cruciate ligament reconstruction. Clin J Sport Med. 2007;17(4):258–62.

    Article  PubMed  Google Scholar 

  86. Button K, Roos PE, Van Deursen RW. Activity progression for anterior cruciate ligament injured individuals. Clin Biomech (Bristol, Avon). 2014;29(2):206–12.

    Article  PubMed  PubMed Central  Google Scholar 

  87. Robbins SM, Maly MR. The effect of gait speed on the knee adduction moment depends on waveform summary measures. Gait Posture. 2009;30(4):543–6.

    Article  PubMed  Google Scholar 

  88. Orishimo KF, Kremenic IJ, Mullaney MJ, et al. Adaptations in single-leg hop biomechanics following anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc. 2010;18(11):1587–93.

    Article  PubMed  Google Scholar 

  89. Mündermann A, Dyrby CO, Andriacchi TP. Secondary gait changes in patients with medial compartment knee osteoarthritis: increased load at the ankle, knee, and hip during walking. Arthritis Rheum. 2005;52(9):2835–44.

    Article  PubMed  Google Scholar 

  90. Simic M, Hinman RS, Wrigley TV, et al. Gait modification strategies for altering medial knee joint load: a systematic review. Arthritis Care Res. 2011;63(3):405–26.

    Google Scholar 

  91. DeVita P, Hortobagyi T, Barrier J. Gait biomechanics are not normal after anterior cruciate ligament reconstruction and accelerated rehabilitation. Med Sci Sports Exerc. 1998;30(10):1481–8.

    Article  CAS  PubMed  Google Scholar 

  92. Ferber R, Osternig LR, Woollacott MH, et al. Bilateral accommodations to anterior cruciate ligament deficiency and surgery. Clin Biomech. 2004;19(2):136–44.

    Article  Google Scholar 

  93. Tellini TL, Lima KO, Alouche SR, et al. Compliant surface after ACL reconstruction and its effects on gait. Acta Sci Health Sci. 2013;35(2):237–42.

    Google Scholar 

  94. Webster KE, Feller JA. Tibial rotation in anterior cruciate ligament reconstructed knees during single limb hop and drop landings. Clin Biomech. 2012;27(5):475–9.

    Article  Google Scholar 

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Author contributions

All authors contributed significantly to the review. Gisela Sole was responsible for the conception of this review; Mandeep Kaur conducted the entire review, with Gisela Sole and Daniel Cury Ribeiro as second and third reviewers; Jean-Claude Theis and Kate Webster provided advice throughout the review. All authors were involved with the final manuscript.

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Authors and Affiliations

  1. Centre for Health, Activity and Rehabilitation Research, School of Physiotherapy, University of Otago, Box 56, Dunedin, 9054, New Zealand

    Mandeep Kaur, Daniel Cury Ribeiro & Gisela Sole

  2. Department of Surgical Sciences, Medical School, University of Otago, Dunedin, New Zealand

    Jean-Claude Theis

  3. School of Allied Health, La Trobe University, Melbourne, VIC, Australia

    Kate E. Webster

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  1. Mandeep Kaur
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Correspondence to Gisela Sole.

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Mandeep Kaur, Daniel Cury Ribeiro, Jean-Claude Theis, Kate Webster, and Gisela Sole declare that they have no conflicts of interest relevant to the content of this review.

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Kaur, M., Ribeiro, D.C., Theis, JC. et al. Movement Patterns of the Knee During Gait Following ACL Reconstruction: A Systematic Review and Meta-Analysis. Sports Med 46, 1869–1895 (2016). https://doi.org/10.1007/s40279-016-0510-4

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