TY - JOUR

T1 - Relationship of Knee Forces to Subjective Function Pre and Post ACL Reconstruction

AU - Smale, Kenneth B

AU - Conconi, Michele

AU - Sancisi, Nicola

AU - Alkjaer, Tine

AU - Krogsgaard, Michael R

AU - Castelli, Vincenzo Parenti

AU - Benoit, Daniel L

PY - 2020

Y1 - 2020

N2 - PURPOSE: Although basic objective measures (e.g. knee laxity, strength, 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-ACL reconstructed states and if these forces relate to their patient's respective subjective functional ability scores.METHODS: Twelve patients performed a hopping task pre and post-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 to 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 IKDC (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 re-injury rate is unlikely to diminish, continuing the heavy financial burden on healthcare systems.Key Terms: Knee, Musculoskeletal modelling, Rehabilitation, patient-specific.

AB - PURPOSE: Although basic objective measures (e.g. knee laxity, strength, 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-ACL reconstructed states and if these forces relate to their patient's respective subjective functional ability scores.METHODS: Twelve patients performed a hopping task pre and post-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 to 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 IKDC (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 re-injury rate is unlikely to diminish, continuing the heavy financial burden on healthcare systems.Key Terms: Knee, Musculoskeletal modelling, Rehabilitation, patient-specific.

U2 - 10.1249/MSS.0000000000002258

DO - 10.1249/MSS.0000000000002258

M3 - Journal article

C2 - 31895297

VL - 52

SP - 1338

EP - 1346

JO - Medicine and Science in Sports and Exercise

JF - Medicine and Science in Sports and Exercise

SN - 0195-9131

IS - 6

ER -