Article

Few studies have investigated the associations between
patient-reported outcome and gait in patients with anterior cruciate ligament
(ACL) injury and reconstruction over time. Because there is an association
between ACL rupture and the presence of osteoarthritis later in life, a better
understanding of these relationships will help to elucidate how patients' gait
pattern may affect pain and symptoms, potentially leading to better treatment for
or preventing the development of knee OA. OBJECTIVE: To evaluate the associations
between gait characteristics and self-reported pain and symptoms before, 6 months
after, and 1 year after anterior cruciate ligament reconstruction. DESIGN:
Prospective cohort study. SETTING: The Human Performance Center at the Orthopedic
Institute at the University of California, San Francisco. PATIENTS: Patients with
full unilateral ACL tears were enrolled. A total of 43 patients were included at
12 months postsurgery. METHODS: The independent variable in this study comprised
specific gait variables in patients who had undergone ACL reconstruction. At each
time point, 3-dimensional motion analysis was performed. Participants also
completed the Knee Osteoarthritis Outcome Score (KOOS) questionnaire. MAIN
OUTCOMES MEASUREMENTS: The primary study outcome measurement was the KOOS and was
planned before data collection began. Partial correlations were used to examine
cross-sectional associations between gait characteristics and KOOS pain and
symptom scores at all time points. In addition, partial correlations were
performed to examine the associations between change in postoperative KOOS from 6
months to 1 year and gait characteristics at baseline and 6 months. RESULTS:
Significant associations between KOOS and gait characteristics were found at all
time points, including an association between peak medial ground reaction force
and pain (r = -0.344, P = .02) and symptoms (r = -0.407, P = .007) at baseline.
CONCLUSIONS: Specific gait variables may be predictive of greater pain and
symptoms and less improvement over time postreconstruction. This could help to
inform rehabilitation exercises post injury and pre reconstruction. LEVEL OF
EVIDENCE: IV.
CI - Copyright (c) 2018 American Academy of Physical Medicine and Rehabilitation.
Published by Elsevier Inc. All rights reserved.

Langue : ANGLAIS