Hip and Knee Kinematics and Kinetics During Landing Tasks After Anterior Cruciate Ligament Reconstruction: A Systematic Review and Meta-Analysis

J Athl Train. 2018 Feb;53(2):144-159. doi: 10.4085/1062-6050-334-16. Epub 2018 Jan 19.

Abstract

Objective: To evaluate the current evidence concerning kinematic and kinetic strategies adopted during dynamic landing tasks by patients with anterior cruciate ligament reconstruction (ACLR).

Data sources: PubMed, Web of Science.

Study selection: Original research articles that evaluated kinematics or kinetics (or both) during a landing task in those with a history of ACLR were included.

Data extraction: Methodologic quality was assessed using the modified Downs and Black checklist. Means and standard deviations for knee or hip (or both) kinematics and kinetics were used to calculate Cohen d effect sizes and corresponding 95% confidence intervals between the injured limb of ACLR participants and contralateral or healthy matched limbs. Data were further stratified by landing tasks, either double- or single-limb landing. A random-effects-model meta-analysis was used to calculate pooled effect sizes and 95% confidence intervals.

Data synthesis: The involved limbs of ACLR patients demonstrated clinically and significantly lower knee-extension moments during double-legged landing compared with healthy contralateral limbs and healthy control limbs (Cohen d range = -0.81 to -1.23) and decreased vertical ground reaction forces when compared with healthy controls, regardless of task (Cohen d range = -0.39 to -1.75).

Conclusions: During single- and double-legged landing tasks, individuals with ACLR demonstrated meaningful reductions in injured-limb knee-extension moments and vertical ground reaction forces. These findings indicate potential unloading of the injured limb after ACLR, which may have significant implications for secondary ACL injury and long-term joint health.

Keywords: biomechanics; injuries; joint moments.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Adult
  • Anterior Cruciate Ligament Injuries / surgery*
  • Anterior Cruciate Ligament Reconstruction / methods*
  • Biomechanical Phenomena
  • Humans
  • Kinetics
  • Knee Joint* / physiology
  • Knee Joint* / physiopathology
  • Postoperative Period