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1998 Publications

GAIT ABNORMALITIES TWO YEARS FOLLOWING ACL AUTOGRAFT SURGERY AND REHABILITATIONby S. Ben-Avi, I.J. Kremenic, S.J. Nicholas and G.W. Gleim, FACSMNISMAT, Lenox Hill Hospital and The Cooper Union, N.Y., N.Y. - last modified 2013-02-09 00:00
Med Sci Sport Exer 30(5), s335, 1998


ACL deficiency has been associated with a specific gait abnormality referred to as "quadriceps avoidance" during stance phase. Briefly, the knees undergo less flexion which in turn decreases the flexion moment around the knee thus requiring less quadriceps activity. In order to see if patients who were fully active two years following ACL autograft surgery manifested gait disturbances, we studied 11 patients who were at least 2 years post-op and 6 controls, free of any knee pathology.

Subjects self selected a preferred walking speed on the treadmill following repeated assessment. Knee motion was monitored by a 3-D ultrasonic motion detecting device during 40 seconds of treadmill walking and averaged over the course of all cycles. Knee angles at heel strike, toe off and maximum flexion were not different.

Stance excursion was significantly reduced bilaterally (P=.047) in ACL subjects (12.3+/-1.5 deg., involved and 14.0+/-1.6 deg., uninvolved) compared to controls (17.8+/-3.0 deg. and 18.4+/-0.6 deg.). with a trend towards reduced flexion excursion in the post-op limb (P=.089). ACL subjects self-selected a slower preferred walking speed (66.6+/-2.6 vs 76.8+/-0.3 m/s, P = .009).

After adjustment for walking speed by covariance analysis, the difference in stance excursion disappeared (P=.424). We conclude that most aspects of gait appear similar between controls and subjects who are greater than 2 years post-ACL surgery, and that differences in knee kinematics can be attributed to differences in preferred walking speed.