Bilateral Differences of Knee Kinematics and Kinetics in Anterior Cruciate Ligament Reconstructed Females during Landing and Cutting

  • Chang, Eun Wook (Inha University, School of Art and Sport, Department of Kinesiology)
  • Received : 2018.07.17
  • Accepted : 2018.09.21
  • Published : 2018.09.30


Objective: Anterior cruciate ligament reconstruction (ACLR) has been considered the primary treatment for anterior cruciate ligament (ACL) injured patient. However, there is little biomechanical evidence regarding bilateral knee joint biomechanics during landing and cutting task after ACLR. Method: Eighteen females with ACLR participated in this investigation. Double leg jump landing (DLJL) and single leg jump cut (SLJC) biomechanics were assessed. Results: During DLJL, the healthy knee showed greater knee valgus angle at initial contact ($^{\circ}$) compared to the injured knee (Injured: $2.93{\pm}2.59$, Healthy: $4.20{\pm}2.46$, t=2.957, p=0.009). There was a significant difference in anterior tibial shear force ($N{\times}N^{-1}$) with greater in the injured knee (Injured: $1.41{\pm}0.39$, Healthy: $1.30{\pm}0.35$, t=2.201, p=0.042). During SLJC, injured knee showed greater knee extension moment ($N^*m{\times}[N^*m]^{-1}$) compared to healthy knee (Injured: $0.51{\pm}0.19$, Healthy: $0.47{\pm}0.17$, t=2.761, p=0.013). However, there was no significant differences between the knees in the other variables. Conclusion: ACLRfemales exhibited a greater knee valgus angle at initial contact and lesser anterior tibial shear force on the healthy knee during double leg jump landing. In addition, ACLR females showed a greater knee extension moment on the injured knee during single leg jump cut.


Supported by : INHA UNIVERSITY


  1. Arendt, E. A., Agel, J. & Dick, R. (1999). Anterior cruciate ligament injury patterns among collegiate men and women. Journal of Athletic Training, 34(2), 86-92.
  2. Bell, A. L., Pedersen, D. R. & Brand, R. A. (1990). A comparison of the accuracy of several hip center location prediction methods. Journal of Biomechanics, 23(6), 617-621.
  3. Chappell, J. D., Herman, D. C., Knight, B. S., Kirkendall, D. T., Garrett, W. E. & Yu, B. (2005). Effect of fatigue on knee kinetics and kinematics in stop-jump tasks. The American Journal of Sports Medicine, 33(7), 1022-1029.
  4. Clarke, S. B., Kenny, I. C. & Harrison, A. J. (2015). Dynamic Knee Joint Mechanics after Anterior Cruciate Ligament Reconstruction. Medicine and Science in Sports and Exercise, 47(1), 120-127.
  5. Di Stasi, S. L., Logerstedt, D., Gardinier, E. S. & Snyder-Mackler, L. (2013). Gait patterns differ between ACL-reconstructed athletes who pass return-to-sport criteria and those who fail. The American Journal of Sports Medicine, 41(6), 1310-1318.
  6. Frank, B., Bell, D. R., Norcross, M. F., Blackburn, J. T., Goerger, B. M. & Padua, D. A. (2013). Trunk and Hip Biomechanics Influence Anterior Cruciate Loading Mechanisms in Physically Active Participants. The American Journal of Sports Medicine, 41(11), 2678-?2683.
  7. Frank, C. B. & Jackson, D. W. (1997). The Science of Reconstruction of the Anterior Cruciate Ligament. The Journal of Bone & Joint Surgery, 79(10), 1556-1576.
  8. Gagnon, D. & Gagnon, M. (1992). The influence of dynamic factors on triaxial net muscular moments at the L5S1 joint during asymmetrical lifting and lowering. Journal of Biomechanics, 25(8), 891-901.
  9. Goerger, B. M., Marshall, S. W., Beutler, A. I., Blackburn, J. T., Wilckens, J. H. & Padua, D. A. (2014). Anterior cruciate ligament injury alters preinjury lower extremity biomechanics in the injured and uninjured leg: the JUMP-ACL study. British Journal of Sports Medicine, 49(3), 188-195.
  10. Griffin, L. Y., Agel, J., Albohm, M. J., Arendt, E. A., Dick, R. W., Garrett, W. E., Garrick, J. G., Hewett, T. E., Huston, L., Ireland, M. L., Johnson, R. J., Kibler, W. B., Lephart, S., Lewis, J. L., Lindenfeld, T. N., Mandelbaum, B. R., Marchak, P., Teitz, C. C. & Wojtys, E. M. (2000). Noncontact anterior cruciate ligament injuries: risk factors and prevention strategies. The Journal of the American Academy of Orthopaedic Surgeons, 8(3), 141-150.
  11. Hewett, T. E., Myer, G. D., Ford, K. R., Heidt, R. S., Colosimo, A. J., McLean, S. G., van den Bogert, A. J., Paterno, M. V. & Succop, P. (2005). Biomechanical measures of neuromuscular control and valgus loading of the knee predict anterior cruciate ligament injury risk in female athletes A prospective study. The American Journal of Sports Medicine, 33(4), 492-501.
  12. Jin, Y. W. (2013). A biomechanical analysis according to passage of rehabilitation training program of ACL patients. Korean Journal of Sport Biomechanics, 23(3), 235-243.
  13. Lee, G. S. & Lim, B.O. (2014). Effects of landing tasks on the anterior cruciate ligament injury risk factors in female basketball players. Korean Journal of Sport Biomechanics, 24(4), 385-390.
  14. Lim, B. O., Ryu, Y. & Kim, K. W., (2013). Effect of gymnasts shoes on risk factors of anterior cruciate ligament injuries during drop landing in female gymnasts. Korean Journal of Sport Biomechanics, 23(3), 219-223.
  15. Logerstedt, D., Di Stasi, S., Grindem, H., Lynch, A., Eitzen, I., Engebretsen, L., Risberg, M. A., Axe, M. J. & Snyder-Mackler, L. (2014). Selfreported knee function can identify athletes who fail return-toactivity criteria up to 1 year after anterior cruciate ligament reconstruction: a delaware-oslo ACL cohort study. The Journal of Orthopaedic and Sports Physical Therapy, 44(12), 914-923.
  16. Markolf, K. L., Burchfield, D. M., Shapiro, M. M., Shepard, M. F., Finerman, G. A. & Slauterbeck, J. L. (1995). Combined knee loading states that generate high anterior cruciate ligament forces. Journal of Orthopaedic Research, 13(6), 930-935.
  17. Paterno, M. V., Rauh, M. J., Schmitt, L. C., Ford, K. R. & Hewett, T. E. (2012). Incidence of contralateral and ipsilateral anterior cruciate ligament (ACL) injury after primary ACL reconstruction and return to sport. Clinical Journal of Sport Medicine, 22(2), 116-121.
  18. Paterno, M. V., Rauh, M. J., Schmitt, L. C., Ford, K. R. & Hewett, T. E. (2014). Incidence of Second ACL Injuries 2 Years After Primary ACL Reconstruction and Return to Sport. The American Journal of Sports Medicine, 42(7), 1567-1573.
  19. Pinczewski, L. A., Lyman, J., Salmon, L. J., Russell, V. J., Roe, J. & Linklater, J. (2007). A 10-Year Comparison of Anterior Cruciate Ligament Reconstructions With Hamstring Tendon and Patellar Tendon Autograft A Controlled, Prospective Trial. The American Journal of Sports Medicine, 35(4), 564-574.
  20. Prodromos, C. C., Han, Y., Rogowski, J., Joyce, B. & Shi, K. (2007). A meta-analysis of the incidence of anterior cruciate ligament tears as a function of gender, sport, and a knee injury-reduction regimen. Arthroscopy: The Journal of Arthroscopic & Related Surgery, 23(12), 1320-1325.
  21. Salmon, L., Russell, V., Musgrove, T., Pinczewski, L. & Refshauge, K. (2005). Incidence and risk factors for graft rupture and contralateral rupture after anterior cruciate ligament reconstruction. Arthroscopy: The Journal of Arthroscopic & Related Surgery, 21(8), 948-957.
  22. Shelbourne, K. D., Sullivan, A. N., Bohard, K., Gray, T. & Urch, S. E. (2009). Return to basketball and soccer after anterior cruciate ligament reconstruction in competitive school-aged athletes. Sports Health: A Multidisciplinary Approach, 1(3), 236-241.
  23. Shimokochi, Y., Yong Lee, S., Shultz, S. J. & Schmitz, R. J. (2009). The relationships among sagittal-plane lower extremity moments: implications for landing strategy in anterior cruciate ligament injury prevention. Journal of Athletic Training, 44(1), 33-38.
  24. Wright, R. W., Dunn, W. R., Amendola, A., Andrish, J. T., Bergfeld, J., Kaeding, C. C., Marx, R. G., McCarty, E. C., Parker, R. D., Wolcott, M., Wolf, B. R. & Spindler, K. P. (2007). Risk of Tearing the Intact Anterior Cruciate Ligament in the Contralateral Knee and Rupturing the Anterior Cruciate Ligament Graft During the First 2 Years After Anterior Cruciate Ligament Reconstruction A Prospective MOON Cohort Study. The American Journal of Sports Medicine, 35(7), 1131-1134.