Movement patterns after anterior cruciate ligament injury: a comparison of patients who compensate well for the injury and those who require operative stabilization

The purpose of this study was to describe kinematic and kinetic differences between a group of ACL deficient subjects who were grouped according to functional ability. Sixteen patients with complete ACL rupture were studied; eight subjects had instability with activities of daily living (non-copers) and eight subjects had returned to all pre-injury activity without limitation (copers). Three-dimensional joint kinematics and kinetics were collected from the knee and ankle during walking, jogging and going up and over a step. Results showed that both groups mitigated the force with which they contacted the floor but non-copers consistently demonstrated less knee flexion in the involved limb. The copers used joint kinematics similar to those of their uninvolved knees and similar to knee motions reported in uninjured subjects. The reduced knee motion in the involved knee of the non-copers did not correlate directly with quadriceps femoris muscle weakness. The data suggest that the non-copers utilize a stabilization strategy which stiffens the knee joint which not only is unsuccessful but may lead to excessive joint contact forces which have the potential to damage articular structures. The copers use a strategy which permits normal knee kinematics and bodes well for joint integrity.  1998 Elsevier Science Ltd. All rights reserved.