Hart Joseph M, Ko Jia-Wei Kevin, Konold Tim, Pietrosimone Brian
University of Virginia, Department of Orthopaedic Surgery, Charlottesville, VA, United States.
Clin Biomech (Bristol). 2010 May;25(4):277-83. doi: 10.1016/j.clinbiomech.2009.12.004. Epub 2010 Jan 25.
Gait adaptations in persons with anterior cruciate ligament (ACL) injuries have been debated. Many studies examine high speed, 3-dimensional video gait analysis to compare knee joint torques during simulated activities of daily living.
We performed a systematic review of the literature for published clinical papers that reported sagittal plane knee joint kinetics in ACL deficient or reconstructed individuals. We calculated weighted effect sizes (Cohen's d) to evaluate the magnitude of differences between the injured limb and the contralateral limb and healthy, uninjured limbs in control subjects.
Ten published papers reported kinetic data in ACL deficient subjects while walking for comparisons to the contralateral side (weighted average d=-0.83, range: -3.21, 1.07), and to healthy control knees (weighted average d=-1.0, range: -3.36, 0.17); four papers reported data during jogging compared to the contralateral side (weighted average d=-0.94, range: -4.15, 0.17), and to controls (weighted average d=-1.42, range: -3.83,-0.2). Four papers reported data for ACL-reconstructed patients compared to healthy controls during walking (weighted average d=-0.94, range: -0.4, -1.77) and jogging (weighted average d=-1.18).
Effect sizes comparing knee joint moments in injured vs. healthy control subjects appear to be slightly higher while jogging than walking, and higher in ACL-deficient patients compared to reconstructions. However, magnitudes are all large. Few studies report stair climbing. Consequently, it is difficult to make inferences with confidence during these tasks.
前交叉韧带（ACL）损伤患者的步态适应性一直存在争议。许多研究采用高速三维视频步态分析来比较模拟日常生活活动期间的膝关节扭矩。
我们对已发表的临床论文进行了系统综述，这些论文报告了ACL缺陷或重建个体的矢状面膝关节动力学。我们计算加权效应量（科恩d值），以评估受伤肢体与对侧肢体以及健康对照受试者未受伤肢体之间差异的大小。
十篇已发表的论文报告了ACL缺陷受试者行走时与对侧相比（加权平均d = -0.83，范围：-3.21, 1.07）以及与健康对照膝关节相比（加权平均d = -1.0，范围：-3.36, 0.17）的动力学数据；四篇论文报告了慢跑时与对侧相比（加权平均d = -0.94，范围：-4.15, 0.17）以及与对照相比（加权平均d = -1.42，范围：-3.83, -0.2）的数据。四篇论文报告了ACL重建患者在行走（加权平均d = -0.94，范围：-0.4, -1.77）和慢跑（加权平均d = -1.18）时与健康对照相比的数据。
比较受伤与健康对照受试者膝关节力矩的效应量在慢跑时似乎比行走时略高，且ACL缺陷患者比重建患者更高。然而，效应量都很大。很少有研究报告爬楼梯情况。因此，在这些任务中很难进行有把握的推断。
