Alarifi Saud M, Herrington Lee C, Althomali Omar W, Alenezi Faisal, Bin Sheeha Bodor, Jones Richard K
Rehabilitation Center, Riyadh First Health Cluster, Ministry of Health, Riyadh, Saudi Arabia.
Centre for Health, Sport and Rehabilitation Sciences, University of Salford, Salford, England, UK.
Orthop J Sports Med. 2025 May 27;13(5):23259671251340302. doi: 10.1177/23259671251340302. eCollection 2025 May.
Biomechanical alterations after anterior cruciate ligament reconstruction (ACLR) may increase the risk of knee reinjury. Furthermore, individuals may experience persistent biomechanical differences in the lower limbs after finishing the rehabilitation program and being ready to return to sport, which may lead to an increase in the risk of reinjury. Limited data exist on individuals after ACLR and biomechanical alterations during running in elite athletes.
To measure kinetic and kinematic data during overground running 6 to 8 months after ACLR in an elite sports cohort.
Controlled laboratory study.
Three-dimensional motion capture tested the running gait of the participants. A total of 34 elite sports professionals who underwent ACLR and were cleared to return to sport and 34 noninjured high-level athlete participants matched by age and sex participated as the control group in this study.
A significant reduction was identified in internal knee extensor moment and knee flexion angles between the ACLR limb and the contralateral side ( = .01, .02) and between the ACLR limb and the control limb ( = .01, .01). The external knee adduction moment was increased significantly between the ACLR and control limbs ( = .01). No other differences were seen in the knee or hip kinetics and kinematics.
After ACLR, the elite participants demonstrated altered knee joint kinematics and kinetics at the time of being cleared to return to sport. These biomechanical deficits suggest that, despite being cleared, the athletes may not have been fully prepared for a safe return to sport, potentially increasing the risk of knee reinjury.
Alterations in kinematics and kinetics in the sagittal plane of the ACLR knee observed during running may predispose participants to joint-related issues, such as patellofemoral pain. Similarly, increased knee adduction moments in the affected limb may indicate unresolved biomechanical deficits. These findings suggest that the elite population may not be fully prepared to resume high-level activity within the 6-month time frame outlined in current rehabilitation protocols. A longer recovery period may be necessary to restore joint kinematics and kinetics to levels more consistent with a safe return to sport.
前交叉韧带重建（ACLR）后生物力学改变可能增加膝关节再次受伤的风险。此外，个体在完成康复计划并准备恢复运动后，下肢可能仍存在持续的生物力学差异，这可能导致再次受伤风险增加。关于ACLR后个体以及精英运动员跑步时生物力学改变的数据有限。
测量精英运动群体在ACLR后6至8个月进行地面跑步时的动力学和运动学数据。
对照实验室研究。
三维运动捕捉测试参与者的跑步步态。本研究共有34名接受ACLR且被批准恢复运动的精英运动专业人员以及34名年龄和性别匹配的未受伤高水平运动员参与者作为对照组。
ACLR侧肢体与对侧肢体之间（P = 0.01，P = 0.02）以及ACLR侧肢体与对照侧肢体之间（P = 0.01，P = 0.01）的膝关节内伸肌力矩和膝关节屈曲角度显著降低。ACLR侧肢体与对照侧肢体之间的膝关节外展力矩显著增加（P = 0.01）。在膝关节或髋关节的动力学和运动学方面未观察到其他差异。
ACLR后，精英参与者在被批准恢复运动时表现出膝关节运动学和动力学改变。这些生物力学缺陷表明，尽管已被批准，但运动员可能尚未完全准备好安全地恢复运动，这可能会增加膝关节再次受伤的风险。
跑步时观察到的ACLR膝关节矢状面运动学和动力学改变可能使参与者易患与关节相关的问题，如髌股疼痛。同样，患侧肢体膝关节外展力矩增加可能表明生物力学缺陷未得到解决。这些发现表明，精英群体可能未完全准备好在当前康复方案规定的6个月时间内恢复高水平活动。可能需要更长的恢复期才能将关节运动学和动力学恢复到更符合安全恢复运动的水平。
