Movement After Knee Surgery Key to Long-Term Success


The way people walk following ACL reconstruction surgery has been found to be connected to whether they have long-term issues, such as osteoarthritis, later on.

The study looked at the walking biomechanics of people who had undergone knee surgery.

Anterior cruciate ligament

The anterior cruciate ligament (ACL) is the band of tissue at the knee that connects the thigh bone to the shin. It is one of the ligaments that enables movement of the lower leg.

An ACL tear is one of the most common knee injuries. It is especially common in people who take part in sports such as football, rugby, tennis and skiing. This is due to the sudden change of direction needed in these activities, which can cause the knee to rotate inwards, putting strain on the ACL. 

Reconstructing tissue

When the ACL is torn, the knee becomes very unstable and there is a reduction in movement ability.

ACL reconstruction is a surgical procedure that involves attaching new tissue into the knee, usually using a tendon from elsewhere in the body.

In more than 80% of people who have ACL reconstruction, their knee function is fully restored. However, around a third of people get osteoarthritis in their knee within 10 years of the operation.

Walking biomechanics

Researchers from the University of North Carolina and Brigham Young University have carried out a study into what causes osteoarthritis in people who have had ACL reconstruction surgery.

They looked at the walking biomechanics of 130 people who had ACL procedures. They were asked to walk on a special walkway which measured their ground reaction force. This was done within 12 months of surgery, and again between 12 and 24 months, and after 24 months.

Physiotherapy and strength training

They found that people who had lingering symptoms after surgery either under-loaded or over-loaded the injured leg by 4–5% more than those who did not have any symptoms.

Lead author Brian Pietrosimone said: “At first look, these changes are relatively small. Yet when you think about a 5% difference every step you take every day, over the course of a month, year or lifetime, you can extrapolate why a seemingly small change could lead to a progressive and chronic disease like post-traumatic osteoarthritis.”

The study highlights the importance of improving movement mechanics after ACL reconstruction, for example closely following physiotherapy programmes and increasing strength training. 



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