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Relationship of Knee Forces to Subjective Function Pre- and Post-ACL Reconstruction

Smale, Kenneth B. ; Conconi, Michele ; Sancisi, Nicola ; Alkjaer, Tine ; Krogsgaard, Michael R. ; Parenti-Castelli, Vincenzo and Benoit, Daniel L. LU (2020) In Medicine and Science in Sports and Exercise 52(6). p.1338-1346
Abstract

Purpose: Although basic objective measures (e.g., knee laxity, strength, and hop tests) have been related to subjective measures of function, associations between knee-specific objective and subjective measures have yet to be completed. The objective was to determine if knee joint contact and ligament forces differ between pre- and post-anterior cruciate ligament (ACL) reconstructed states and if these forces relate to their patient's respective subjective functional ability scores. Methods: Twelve patients performed a hopping task before and after reconstruction. Magnetic resonance images and OpenSim were used to develop patient-specific models in static optimization and joint reaction analyses. Questionnaires concerning each patient's... (More)

Purpose: Although basic objective measures (e.g., knee laxity, strength, and hop tests) have been related to subjective measures of function, associations between knee-specific objective and subjective measures have yet to be completed. The objective was to determine if knee joint contact and ligament forces differ between pre- and post-anterior cruciate ligament (ACL) reconstructed states and if these forces relate to their patient's respective subjective functional ability scores. Methods: Twelve patients performed a hopping task before and after reconstruction. Magnetic resonance images and OpenSim were used to develop patient-specific models in static optimization and joint reaction analyses. Questionnaires concerning each patient's subjective functional ability were also collected and correlated with knee joint contact and ligament forces. Results: No significant differences were observed between deficient and reconstructed groups with respect to knee joint contact or ligament forces. Nevertheless, there were several significant (P < 0.05) moderate to strong correlations between subjective and objective measures including Tegner activity level to contact force in both states (r = 0.67-0.76) and International Knee Documentation Committee to compressive and anterior shear forces (r = 0.64-0.66). Conclusion: Knee-specific objective measures of a patient's functional capacity can represent their subjective ability, which explains this relationship to a greater extent than past anatomical and gross objective measures of function. This consolidation is imperative for improving the current rehabilitation schema as it allows for external validation of objective and subjective functional measures. With poor validation of subjective function against objective measures of function, the reinjury rate is unlikely to diminish, continuing the heavy financial burden on health care systems.

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author
; ; ; ; ; and
publishing date
type
Contribution to journal
publication status
published
keywords
KNEE, MUSCULOSKELETAL MODELING, PATIENT-SPECIFIC, REHABILITATION
in
Medicine and Science in Sports and Exercise
volume
52
issue
6
pages
1338 - 1346
publisher
Lippincott Williams & Wilkins
external identifiers
  • pmid:31895297
  • scopus:85085232509
ISSN
0195-9131
DOI
10.1249/MSS.0000000000002258
language
English
LU publication?
no
additional info
Publisher Copyright: Copyright © 2019 by the American College of Sports Medicine
id
ec01937e-1d5a-4f94-9f99-b4421127252d
date added to LUP
2023-08-24 16:50:54
date last changed
2024-04-05 23:22:01
@article{ec01937e-1d5a-4f94-9f99-b4421127252d,
  abstract     = {{<p>Purpose: Although basic objective measures (e.g., knee laxity, strength, and hop tests) have been related to subjective measures of function, associations between knee-specific objective and subjective measures have yet to be completed. The objective was to determine if knee joint contact and ligament forces differ between pre- and post-anterior cruciate ligament (ACL) reconstructed states and if these forces relate to their patient's respective subjective functional ability scores. Methods: Twelve patients performed a hopping task before and after reconstruction. Magnetic resonance images and OpenSim were used to develop patient-specific models in static optimization and joint reaction analyses. Questionnaires concerning each patient's subjective functional ability were also collected and correlated with knee joint contact and ligament forces. Results: No significant differences were observed between deficient and reconstructed groups with respect to knee joint contact or ligament forces. Nevertheless, there were several significant (P &lt; 0.05) moderate to strong correlations between subjective and objective measures including Tegner activity level to contact force in both states (r = 0.67-0.76) and International Knee Documentation Committee to compressive and anterior shear forces (r = 0.64-0.66). Conclusion: Knee-specific objective measures of a patient's functional capacity can represent their subjective ability, which explains this relationship to a greater extent than past anatomical and gross objective measures of function. This consolidation is imperative for improving the current rehabilitation schema as it allows for external validation of objective and subjective functional measures. With poor validation of subjective function against objective measures of function, the reinjury rate is unlikely to diminish, continuing the heavy financial burden on health care systems.</p>}},
  author       = {{Smale, Kenneth B. and Conconi, Michele and Sancisi, Nicola and Alkjaer, Tine and Krogsgaard, Michael R. and Parenti-Castelli, Vincenzo and Benoit, Daniel L.}},
  issn         = {{0195-9131}},
  keywords     = {{KNEE; MUSCULOSKELETAL MODELING; PATIENT-SPECIFIC; REHABILITATION}},
  language     = {{eng}},
  month        = {{06}},
  number       = {{6}},
  pages        = {{1338--1346}},
  publisher    = {{Lippincott Williams & Wilkins}},
  series       = {{Medicine and Science in Sports and Exercise}},
  title        = {{Relationship of Knee Forces to Subjective Function Pre- and Post-ACL Reconstruction}},
  url          = {{http://dx.doi.org/10.1249/MSS.0000000000002258}},
  doi          = {{10.1249/MSS.0000000000002258}},
  volume       = {{52}},
  year         = {{2020}},
}