Sagittal plane translation during level walking in poor-functioning and well-functioning patients with anterior cruciate ligament deficiency

Abstract

Background: Some patients with anterior cruciate ligament deficiency can function well and participate in high-level sports, whereas others have functional limitations even during activities of daily living.

Hypothesis: Patients who function well after an anterior cruciate ligament injury can stabilize the knee joint during gait by an anterior positioning of the tibia.

Study design: Controlled laboratory study.

Methods: Sagittal tibial translation was registered with the CA-4000 electrogoniometer, during the Lachman test and walking, in 20 patients with a unilateral anterior cruciate ligament injury. Eleven patients functioned well (Lysholm score > or = 84), and 9 patients had poor knee function (Lysholm score < 84).

Results: During gait, the well-functioning group had 24% greater anterior translation in the injured leg compared to the noninjured leg. In the poor-functioning group, the anterior translation in the injured leg was 16% smaller compared to the noninjured leg (P = .0003). Tibial translation during the Lachman test was similar in the injured leg in the 2 groups.

Conclusion: Patients who function well position their tibiae near the anterior border of the joint play. This position may encourage functional stability.

Clinical relevance: Rehabilitation that emphasizes training to stabilize the tibia in an anterior position may improve functional stability of the anterior cruciate ligament-deficient knee.