Dataset Information

Biomechanical Markers of Forward Hop-Landing After ACL-Reconstruction: A Pattern Recognition Approach.

ABSTRACT: Biomechanical changes after anterior cruciate ligament reconstruction (ACLR) may be detrimental to long-term knee-joint health. We used pattern recognition to characterise biomechanical differences during the landing phase of a single-leg forward hop after ACLR. Experimental data from 66 individuals 12-24 months post-ACLR (28.2 ± 6.3 years) and 32 controls (25.2 ± 4.8 years old) were input into a musculoskeletal modelling pipeline to calculate joint angles, joint moments and muscle forces. These waveforms were transformed into principal components (features), and input into a pattern recognition pipeline, which found 10 main distinguishing features (and 8 associated features) between ACLR and control landing biomechanics at significance [Formula: see text]. Our process identified known biomechanical characteristics post-ACLR: smaller knee flexion angle; less knee extensor moment; lower vasti, rectus femoris and hamstrings forces. Importantly, we found more novel and less well-understood adaptations: smaller ankle plantar flexor moment; lower soleus forces; and altered patterns of knee rotation angle, hip rotator moment and knee abduction moment. Crucially, we identified, with high certainty, subtle aberrations indicating landing instability in the ACLR group for: knee flexion and internal rotation angles and moments; hip rotation angles and moments; and lumbar rotator and bending moments. Our findings may benefit rehabilitation and assessment for return-to-sport 12-24 months post-ACLR.

SUBMITTER: Sritharan P

PROVIDER: S-EPMC8847210 | biostudies-literature | 2022 Mar

REPOSITORIES: biostudies-literature

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Biomechanical Markers of Forward Hop-Landing After ACL-Reconstruction: A Pattern Recognition Approach.

Sritharan Prasanna P Muñoz Mario A MA Pivonka Peter P Bryant Adam L AL Mokhtarzadeh Hossein H Perraton Luke G LG

Annals of biomedical engineering 20220131 3

Biomechanical changes after anterior cruciate ligament reconstruction (ACLR) may be detrimental to long-term knee-joint health. We used pattern recognition to characterise biomechanical differences during the landing phase of a single-leg forward hop after ACLR. Experimental data from 66 individuals 12-24 months post-ACLR (28.2 ± 6.3 years) and 32 controls (25.2 ± 4.8 years old) were input into a musculoskeletal modelling pipeline to calculate joint angles, joint moments and muscle forces. These ...[more]

PMID: 35099657

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Project description:BackgroundThe efficacy of a neuromuscular training (NMT) program to ameliorate known hip biomechanical risk factors for athletes with anterior cruciate ligament reconstruction (ACLR) is currently unknown. Purpose/Hypothesis: The purpose was to quantify the effects of an NMT program on hip biomechanics among athletes with ACLR and to compare posttraining hip biomechanics with a control group. The hypotheses were that known hip biomechanical risk factors of anterior cruciate ligament (ACL) injury would be significantly reduced among athletes with ACLR after the NMT program and that posttraining hip biomechanics between the ACLR and control cohorts would not differ.Study designControlled laboratory study.MethodsTwenty-eight athletes (n = 18, ACLR; n = 10, uninjured) completed a 12-session NMT program. Biomechanical evaluation of a jump-landing task was done before and after completion of the program. Repeated measures analysis of variance was performed to understand the effect of NMT within the ACLR cohort. Two-way analysis of variance was used to compare both groups. Post hoc testing was done for significant interactions. Hip biomechanical variables at initial contact are reported.ResultsThe athletes with ACLR who completed the NMT program had a significant session × limb interaction ( P = .01) for hip external rotation moment and a significant main effect of session for hip flexion angle ( P = .049) and moment ( P < .001). There was a significant change for the involved ( P = .04; 528% increase) and uninvolved ( P = .04; 57% decrease) limbs from pre- to posttraining for hip rotation moment. The ACLR cohort had an increase in hip flexion angle (14% change) and a decrease in hip flexion moment (65% change) from pre- to posttraining. Posttraining comparison for these same hip biomechanical variables of interest revealed no significant interactions ( P > .05) between the ACLR and control cohorts. There was a significant main effect of group ( P = .02) for hip flexion angle, as the ACLR cohort demonstrated greater hip flexion angle than that of the control group.ConclusionFor athletes with ACLR, hip biomechanical measures of ACL injury risk show significant improvements after completion of an NMT program.Clinical relevanceAthletes with ACLR who are participating in an NMT program may ameliorate known hip biomechanical risk factors for an ACL injury.

Project description:Though rehabilitation attempts to correct "stiff knee gait" and control for dynamic limb valgus after anterior cruciate ligament reconstruction (ACLR), impaired biomechanics often persist when an individual is cleared to return to sport (RTS). Reduced knee extension moments (KEMs) and knee flexion angles (KFAs) often continue. While at the hip, increased hip adduction angles (HADDAs) and hip internal rotation angles (HIRAs) often persist in spite of dynamic hip stabilization exercises. Sled towing and weighted vest tasks increase KEM and hip extension moments (HEMs) in healthy individuals, yet biomechanical profiles during these tasks after ACLR are unknown.Weighted gait will increase KEM, HEM, hip abduction moments (HABDMs), and hip external rotation moments (HERMs) and will not increase unwanted biomechanics (limb asymmetries, HIRA, HADDA) compared with normal gait.Controlled laboratory study.Level 4.Fourteen men and 24 women who were 5 to 12 months after ACLR, had no concomitant ligament injuries, and were cleared to RTS were recruited. Sexes were evaluated independently given the sex-specific incidence to ACL injury, reinjury, and gait responses to certain interventions. Joint moment impulses and peak angles over the first 25% of stance were compared between limbs and across tasks (eg, unweighted gait, sled 50% body weight [BW], and vest 50% BW).Men showed that weighted gait increased KEM, HEM, HERM, HADBM (vest only), HADDA, HIRA (sled only), and KFA. Asymmetrical KEM and KFA existed across tasks. Women showed that weighted gait increased KEM, HEM, HERM, HADBM (vest only), HFA (sled only), HADDA, and KFA. Asymmetrical KEM, HEM, HIRA, and KFA (sled only) existed across tasks.Weighted gait generally increased joint moments. Unwanted biomechanics were unique for each weighted gait task.Though joint moments increased, both tasks created unwanted biomechanics after ACLR. Persistent hip (women only) and KEM asymmetries across tasks when cleared to RTS are concerning given the relationship among these biomechanics and decreased functional performance.

Project description:Background:There is growing interest in assessing psychological well-being in patients after anterior cruciate ligament (ACL) reconstruction. It is unknown whether an assessment of psychological outcome in addition to tests of muscle function can facilitate decisions on return to sport (RTS). Therefore, the aim of this study was to evaluate passing rates in different physical RTS test batteries, with and without the inclusion of psychological outcome measures 1?year after ACL reconstruction. Method:In this cross-sectional cohort study a total of 320 patients (51% men) aged 18-65?years were included 1?year after ACL reconstruction. Passing rates on different muscle function (MF) test batteries (with results presented as Limb Symmetry Index (LSI)), consisting of knee extension and flexion strength tests, 3 hop tests, and 2 psychological patient-reported outcomes (PROs); Quality of Life subscale from the Knee injury and Osteoarthritis Outcome Score (KOOS QoL) and ACL Return to Sport after Injury (ACL-RSI), were evaluated 1?year after ACL reconstruction. Muscle function test batteries comprised: 2 MF tests (vertical hop and hop for distance; pass?=?90% LSI); 2 MF tests and 2 PRO (pass?=?90% LSI, 62.5 points on KOOS QoL and 76.6 points on ACL-RSI), 5 MF tests (2 strength and 3 hop tests, pass?=?90% LSI), and 5 MF tests and 2 PRO (pass?=?90% LSI, 62.5 points on KOOS QoL and 76.6 points on ACL-RSI). Results:Passing rates in the different test batteries were 47% for 2 MF tests, 19% for 2 MF tests and 2 PROs, 29% for 5 MF tests and 13% for 5 MF tests and 2 PROs. The use of psychological PROs together with tests of muscle function gave the lowest passing rate (13%). There was a very strong correlation between passing 2 hop tests and 2 PROs and passing 5 MF tests (r??=?0.41) as well as passing 5 MF tests and 2 PROs (r??=?0.79). Conclusion:The use of hop tests together with psychological PROs provides a clinician-friendly RTS test battery for assessment 1?year after ACL reconstruction as the passing rate was 19% when using 2 hop-tests combined with 2 PROs, compared with 29% when using 5 tests of MF requiring advanced testing equipment.

Project description:Improved biomechanical and clinical outcomes are seen when the femoral tunnels of the anterior cruciate ligament (ACL) are placed in the center of the femoral insertion. The transtibial (TT) technique has been shown to be less capable of this than an anteromedial (AM) portal approach but is more familiar to surgeons and less technically challenging. A hybrid transtibial (HTT) technique using medial portal guidance of a transtibial guide wire without knee hyperflexion may offer anatomic tunnel placement while maintaining the relative ease of a TT technique.To evaluate the anatomic and biomechanical performance of the HTT technique compared with TT and AM approaches.Controlled laboratory study.Thirty-six paired, fresh-frozen human knees were used. Twenty-four knees (12 pairs) underwent all 3 techniques (TT, AM, HTT) for femoral tunnel placement, with direct measurement of femoral insertional overlap and femoral tunnel length. The remaining 12 knees (6 pairs) underwent completed reconstructions to evaluate graft anisometry and tunnel orientation, with each technique performed in 4 specimens and tested using motion sensors with a quad-load induced model. Graft length changes and graft/femoral tunnel angle were measured at varying degrees of flexion.Percentage overlap of the femoral insertion averaged 37.0% ± 28.6% for TT, 93.9% ± 5.6% for HTT, and 79.7% ± 7.7% for AM, with HTT significantly greater than both TT (P = .007) and AM (P = .001) approaches. Graft length change during knee flexion (anisometry) was 30.1% for HTT, 12.8% for AM, and 8.5% for TT. When compared with the TT approach, HTT constructs exhibited comparable graft-femoral tunnel angulation (TT, 150° ± 3° vs HTT, 142° ± 2.3°; P < .001) and length (TT, 42.6 ± 2.8 mm vs HTT, 38.5 ± 2.0 mm; P = .12), while AM portal tunnels were significantly shorter (31.6 ± 1.6 mm; P = .001) and more angulated (121° ± 6.5°; P < .001).The HTT technique avoids hyperflexion and maintains femoral tunnel orientation and length, similar to the TT technique, but simultaneously achieves anatomic graft positioning.The HTT technique offers an anatomic alternative to an AM portal approach while maintaining the technical advantages of a traditional TT reconstruction.

Dataset Information

Biomechanical Markers of Forward Hop-Landing After ACL-Reconstruction: A Pattern Recognition Approach.

Publications

Biomechanical Markers of Forward Hop-Landing After ACL-Reconstruction: A Pattern Recognition Approach.

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