Patellofemoral joint loads in ACL reconstructed elite athletes during running at time of return to sport

Herrington, LC; Alarifi, SM; Jones, R

Abstract

Background: Patellofemoral joint pain and degeneration is common in patients who undergo ACL reconstruction (ACLR). The presence of patellofemoral joint pain significantly impacts on the ability to continue to participate in sport and may even have a bearing on participation in activities of daily living. What is currently unclear is the mechanisms behind this process, previous research has identified altered patellofemoral joint loading in individuals with patellofemoral joint pain when running. It is unclear if this process is occurring following ACLR.

Hypothesis/Purpose: To assess the patellofemoral joint stresses during running in ACLR knees and compare the findings to non-injured knee and matched control knees.


Study Design: Cohort study
Methods: Thirty four elite sports practitioners who had undergone ACLR and thirty four age and sex matched controls participated in the study. The participants had their running gait assessed using 3D motion capture, and knee loads and forces calculated using inverse dynamics.


Results: There was a significance difference in knee extensor moment, knee flexion angles, patellofemoral contact force (around 23% greater), and patellofemoral contact pressure (around 27% greater) between the ACLR and non-injured limb (p≤0.04) and the ACLR and control limb (p≤0.04), with no significant difference between the non-injured and control limbs (p≥0.44).


Conclusion: Significantly greater levels of patellofemoral joint stress and load were found in the ACLR knee compared to the non-injured and control knees.
Clinical Relevance: Altered levels of patellofemoral stress in the ACLR knee during running may predispose these individuals to patellofemoral joint pain.

• Journal Article Type: Article
• Acceptance Date: Jul 20, 2017
• Online Publication Date: Jul 27, 2017
• Publication Date: Oct 1, 2017
• Deposit Date: Aug 18, 2017
• Publicly Available Date: Aug 18, 2017
• Journal: The American Journal of Sports Medicine
• Print ISSN: 0363-5465
• Electronic ISSN: 1552-3365
• Publisher: SAGE Publications
• Volume: 45
• Issue: 12
• Pages: 2812-2816
• DOI: https://doi.org/10.1177/0363546517716632
• Publisher URL: http://dx.doi.org/10.1177/0363546517716632
• Related Public URLs: http://journals.sagepub.com/home/ajs