Gait Patterns After Posterior Cruciate Ligament Injury: A Comparison of Symptomatic and Asymptomatic Patients

Abstract

This study examined chronic, isolated posterior cruciate ligament (PCL) rupture patients, dividing them into symptomatic and asymptomatic groups according to whether they displayed obvious symptoms in daily activities. Each group comprised 10 patients while 10 healthy, young individuals were adopted as the control group. Using a three-dimensional motion analysis system and force plates, the gait patterns of the PCL-deficient patients were analyzed from both kinematics and kinetics perspectives to identify whether they differed from the control group and to compare symmetry between the injured and uninjured sides. The results showed that the symptomatic PCL-deficient group was closer to \normal", and the asymptomatic PCL-deficient group showed less knee extension moment and lower power absorption in the terminal stance than the control group. Additionally, the symptomatic PCLdeficient group appeared to have a relatively symmetric gait while the asymptomatic PCLdeficient group primarily showed an asymmetric gait also occurring in the terminal stance, including less joint moment and lower power absorption of the hip and knee, and lower vertical . Downloaded from www.worldscientific.com by FLINDERS UNIVERSITY LIBRARY on 02/07/15. For personal use only.ground reaction force (GRF). Regarding the gait adaptations of the asymptomatic PCLdeficient group these compensation mechanisms are most likely to have been produced in order to assist in joint stabilization and reduce symptoms in joints.

Lower Limb Biomechanics During Level Walking After an Isolated Posterior Cruciate Ligament Rupture

“…Our results showed that during the terminal stance phase, extension moments were significantly smaller in the involved leg of the PCL-d group than in the uninvolved leg of the PCL-d group, which may decrease force and prevent the tibia from posterior translation during the extension movement. The study of Liu et al 28 showed that the asymptomatic PCL-deficient knee had smaller extension moments in the terminal stance than those seen in a control group, while the values of the symptomatic PCL-deficient group were closer to those of healthy participants. In our study, patients in the PCL-d group had no symptoms during level walking; therefore, knee extension deficiency could be a result of the adaptive gait pattern after a PCL rupture.…”

“…Most previous studies 9,11,16,28 regarding PCL ruptures have focused on knee kinematics in the sagittal plane of the PCL-deficient leg during the stance phase of walking and found no significant difference among the involved leg of the PCL-d group, the uninvolved leg of the PCL-d group, and a control group. Our study not only focused on the knee kinematics and kinetics of legs in the PCL-d group in 3D planes but also on the hip and ankle in 3D planes.…”

“…27 Even for walking, the most essential and routine daily activity, the influence of PCL deficiency remains unclear. 9,28,32,41 Some of these studies are in vitro studies, 23,25 while others 4,10,13,21,25,29 are in vivo, but both types only analyze static or quasistatic movements. Many issues related to lower limb biomechanics for patients with isolated PCL ruptures remain unclear and are worthy of further investigation.…”