Measures of Agility and Single-Legged Balance as Clinical Assessments in Patients With Anterior Cruciate Ligament Reconstruction and Healthy Individuals

Context Current clinical assessments used for patients with anterior cruciate ligament reconstruction (ACLR) may not enable clinicians to properly identify functional deficits that have been found in laboratory studies. Establishing muscular-function assessments, through agility and balance tasks, that can properly differentiate individuals with ACLR from healthy, active individuals may permit clinicians to detect deficits that increase the risk for poor outcomes. Objective To compare lower extremity agility and balance between patients with ACLR and participants serving as healthy controls. Design Case-control study. Setting Controlled laboratory. Patients or Other Participants A total of 47 volunteers in 2 groups, ACLR (9 males, 11 females; age = 23.28 ± 5.61 years, height = 173.52 ± 8.89 cm, mass = 70.67 ± 8.89 kg) and control (13 males, 12 females; age = 23.00 ± 6.44, height = 172.50 ± 9.24, mass = 69.81 ± 10.87 kg). Main Outcome Measure(s) Participants performed 3 timed agility tasks: Agility T Test, 17-hop test, and mat-hopping test. Balance was assessed in single-legged (SL) stance in 3 positions (straight knee, bent knee, squat) on 2 surfaces (firm, foam) with the participants' eyes open or closed for 10-second trials. Agility tasks were measured for time to completion. Eyes-open balance tasks were measured using center-of-pressure average velocity, and eyes-closed balance tasks were measured using the Balance Error Scoring System. Results For the Agility T Test, the ACLR group had slower times than the control group (P = .05). Times on the Agility T Test demonstrated moderate to strong positive relationships for unipedal measures of agility. The ACLR group had greater center-of-pressure average velocity in the SL bent-knee position than the control group. No differences were found between groups for the SL straight-knee and SL-squat balance tasks (P > .05). No differences in errors were present between groups for the eyes-closed balance tasks (P > .05). Conclusions The ACLR group demonstrated slower bipedal agility times and decreased postural stability when assessed in an SL bent-knee position compared with the control group.

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THE EFFECTS OF NEUROMUSCULAR ELECTRICAL STIMULATION IN ASSOCIATION WITH WHEY PROTEIN SUPPLEMENTATION AFTER ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION

Acta Ortopédica Brasileira ◽

10.1590/1413-785220212906237983 ◽

2021 ◽

Vol 29 (6) ◽

pp. 316-322

Author(s):

GABRIELA OTÍLIA MENDONÇA ◽

MARIA LUIZA BIANCHINI SEVERINO ◽

KELLE MOREIRA DE OLIVEIRA ◽

MARCELO LIMA DE OLIVEIRA ◽

GIOVANE GALDINO DE SOUZA ◽

...

Keyword(s):

Anterior Cruciate Ligament ◽

Electrical Stimulation ◽

Anterior Cruciate Ligament Reconstruction ◽

Ligament Reconstruction ◽

Cruciate Ligament ◽

Neuromuscular Electrical Stimulation ◽

Electromyographic Activity ◽

Eyes Closed ◽

Eyes Open ◽

Anterior Cruciate

ABSTRACT Objective: To analyze the effects of neuromuscular electrical stimulation of the femoral quadriceps associated or not with whey protein supplementation on the electromyographic activity and body mass distribution in volunteers undergoing anterior cruciate ligament reconstruction. Methods: 24 volunteers were randomly divided into three groups: basal control, whey protein in association with neuromuscular electrical stimulation, and neuromuscular electrical stimulation alone. Results: In the postoperative evaluation, during the mini squat, the basal group showed a decrease in the electromyographic activity of the vastus medialis (p = 0.005, eyes open; p = 0.003, eyes closed), vastus lateralis (p = 0.005, eyes open; p = 0.020; eyes closed) and rectus femoris (p = 0.075, eyes open; p = 0.074, eyes closed) and of body mass distribution in the injured limb (p < 0.001, eyes open; p < 0.001, eyes closed), and in the healthy limb (p < 0.001, eyes open; p < 0.001, eyes closed). Conclusion: The early use of neuromuscular electrical stimulation of the quadriceps femoris maintained the electromyographic activity of the vastus medialis and vastus lateralis muscles and prevented asymmetries in body mass distribution 15 days after anterior cruciate ligament reconstruction. Level of Evidence I, High quality randomized trial.

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Outcomes More Than 2 Years After Meniscal Repair for Longitudinal Tears of the Lateral Meniscus Combined With Anterior Cruciate Ligament Reconstruction

The American Journal of Sports Medicine ◽

10.1177/0363546520981976 ◽

2021 ◽

pp. 036354652098197

Author(s):

Akira Tsujii ◽

Yasukazu Yonetani ◽

Kazutaka Kinugasa ◽

Tomohiko Matsuo ◽

Kenji Yoneda ◽

...

Keyword(s):

Ligament Reconstruction ◽

Cruciate Ligament ◽

Lateral Meniscus ◽

Complete Healing ◽

Control Group ◽

Study Group ◽

Meniscal Extrusion ◽

Second Look ◽

Anterior Cruciate

Background: Meniscal function after repair of longitudinal tears of the lateral meniscus (LM) with anterior cruciate ligament reconstruction (ACLR) has not been comprehensively investigated. Purpose: To evaluate not only the clinical outcomes and radiographic findings of patients who underwent repair of longitudinal tears of the LM combined with ACLR but also the healing status of the repaired meniscus and changes in chondral status with second-look arthroscopy. Study Design: Case series; Level of evidence, 4. Methods: Among 548 patients who underwent primary anatomic ACLR at our institution between 2010 and 2017, 39 who had concomitant longitudinal tears of the LM and underwent repair were studied. During follow-up for more than 2 years, all patients were evaluated clinically (pain, range of motion, swelling, and knee instability) and with imaging (plain radiograph and magnetic resonance imaging [MRI]), and compared with a matched control group (based on age, sex, body mass index, and follow-up period) without any concomitant injuries who underwent ACLR. Measurements on MRI were recorded preoperatively, immediately after surgery, and at final follow-up, and the change in the values over time was assessed. Of the 39 patients in each group, 24 were assessed by second-look arthroscopy with hardware removal 2 years postoperatively. Results: The mean follow-up times of the study and control group were at a mean of 42.4 and 45.4 months, respectively. There were no significant differences in clinical findings, lateral joint space narrowing on radiographs, and chondral status at the lateral compartment between groups, whereas lateral and posterior meniscal extrusion on MRI progressed significantly in the study group (0.43 ± 1.0 mm vs -0.29 ± 1.1 mm, P = .003; 1.9 ± 1.9 mm vs 0.14 ± 1.1 mm, P < .0001, respectively). Second-look arthroscopy revealed complete healing in 12 patients (50%), partial healing in 9 (37.5%), and failure in 3 (12.5%) in the study group, and no new tear in the control group. Conclusion: The clinical and imaging outcomes after repair of longitudinal tears of the LM combined with anatomic ACLR were successful and comparable with those after isolated ACLR without any other injuries at 42 months postoperatively, although meniscal extrusion showed progression on coronal/sagittal MRI. Based on the MRI findings and the result that only half of patients achieved complete healing, meniscal function could not be fully restored even after repair. Although degenerative changes were not apparent, longer-term follow-up is needed.

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Comparison of the Position-Matching and Position-Reproducing Tasks to Detect Deficits in Knee Position Sense After Reconstruction of the Anterior Cruciate Ligament

Journal of Sport Rehabilitation ◽

10.1123/jsr.2017-0275 ◽

2020 ◽

Vol 29 (1) ◽

pp. 87-92

Author(s):

Takuma Hoshiba ◽

Hiroki Nakata ◽

Yasuaki Saho ◽

Kazuyuki Kanosue ◽

Toru Fukubayashi

Keyword(s):

Anterior Cruciate Ligament ◽

Acl Reconstruction ◽

Sport Participation ◽

Cruciate Ligament ◽

Knee Extension ◽

Position Sense ◽

Matching Task ◽

Control Group ◽

Knee Position ◽

Anterior Cruciate

Context: Deficits in knee position sense following reconstruction of the anterior cruciate ligament (ACL) can delay an athlete’s return to sport participation and increase the risk of reinjury. Deficits in position sense postreconstruction have been evaluated using either a position-reproducing or position-matching task. Objective: The aim of our study was to combine both to determine which assessment would be more effective to identify deficits in knee position sense. Design: Longitudinal laboratory-based study. Participants: Eleven athletes (6 men and 5 women; mean age, 20.5 [1.2] y), who had undergone ACL reconstruction with an ipsilateral hamstring autograft, and 12 age-matched controls. Interventions: Position sense was evaluated at 6 and 12 months postreconstruction and once for the control group. In addition, peak isokinetic knee extension and flexion strength, at 60°/s and 180°/s, was assessed for the ACL reconstruction group to evaluate possible influences of muscle strength on knee joint position sense. Main Outcome Measures: The variables include the angular differences between the reference limb and indicator limb, and peak torque values of isokinetic knee extension and flexion. Results: Significant matching differences were identified at 6 months postsurgery on the position-matching task, but not at 12 months postsurgery. No significant between-group and within-subject differences were identified on the position-reproducing task. No significant matching errors were identified for the control group. There was no correlation between errors in position sense and maximum isokinetic strength. Conclusion: The position-matching task is more sensitive than the position-reproducing task to identify deficits in knee position sense over the first year following ACL reconstruction surgery.

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Maximal stability limits in adolescents with Tourette syndrome

Journal of Advanced Pediatrics and Child Health ◽

10.29328/journal.japch.1001024 ◽

2021 ◽

Vol 4 (1) ◽

pp. 013-022

Author(s):

Blanchet Mariève ◽

Prince François ◽

Lemay Martin ◽

Chouinard Sylvain ◽

Messier Julie

Keyword(s):

Postural Control ◽

Tourette Syndrome ◽

Center Of Pressure ◽

Phase 1 ◽

Sensory Information ◽

Control Group ◽

Eyes Closed ◽

Highly Sensitive ◽

Eyes Open ◽

Stability Limits

We explored if adolescents with Gilles de la Tourette syndrome (GTS) had functional postural control impairments and how these deficits are linked to a disturbance in the processing and integration of sensory information. We evaluated the displacements of the center of pressure (COP) during maximal leaning in four directions (forward, backward, rightward, leftward) and under three sensory conditions (eyes open, eyes closed, eyes closed standing on foam). GTS adolescents showed deficits in postural stability and in lateral postural adjustments but they had similar maximal COP excursion than the control group. The postural performance of the GTS group was poorer in the eyes open condition (time to phase 1 onset, max-mean COP). Moreover, they displayed a poorer ability to maintain the maximum leaning position under the eyes open condition during mediolateral leaning tasks. By contrast, during forward leaning, they showed larger min-max ranges than control subjects while standing on the foam with the eyes closed. Together, these findings support the idea that GTS produces subclinical postural control deficits. Importantly, our results suggest that postural control disorders in GTS are highly sensitive to voluntary postural leaning tasks which have high demand for multimodal sensory integration.

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Examining the Relationship Between a Neuromuscular Control Baseline Battery for Sport-Related Concussion and Anterior Cruciate Ligament Injury Risk

Neurology ◽

10.1212/01.wnl.0000801936.89376.f8 ◽

2021 ◽

Vol 98 (1 Supplement 1) ◽

pp. S21.2-S22

Author(s):

Ryan Moran

Keyword(s):

Anterior Cruciate Ligament ◽

Lower Extremity ◽

Cruciate Ligament ◽

Neuromuscular Control ◽

Ligament Injury ◽

Jump Landing ◽

Eyes Closed ◽

Eyes Open ◽

Anterior Cruciate ◽

The Relationship

ObjectiveTo examine the relationship between the m-CTSIB and Landing Error Scoring System in a sample of collegiate female athletes.BackgroundRecent literature has linked concussion and neuromuscular deficits in the lower extremity after injury. Neuromuscular control is frequently assessed using balance measures for concussion, but also dynamically to identify anterior cruciate ligament injury (ACL) risk via jump-landing movement screening.Design/MethodsThirty-nine healthy, collegiate female soccer (n = 22) and volleyball (n = 17) athletes completed the modified-Clinical Test of Sensory Interaction of Balance (m-CTSIB) and the Landing Error Scoring System (LESS). Measures consisted of total m-CTSIB sway index scores on individual conditions (firm surface eyes open [condition 1] and eyes closed [2], foam surface eyes open [3] and eyes closed [4]), m-CTSIB overall score, and total LESS errors. LESS scores were also categorized into a low (0–4 errors) and high (5 + errors) risk to determine if athletes with worse neuromuscular control on the LESS has worse balance on the m-CTSIB. A Spearman's rank-order correlation was conducted to determine the strength of the relationship between LESS and m-CTSIB performance. A series of Mann-Whitney U test were performed to determine differences between low and high LESS performance on m-CTSIB performance.ResultsThere was a weak, negative correlation between LESS and m-CTSIB performance (rs(37) = −0.153, p = 0.35). Further, there were no differences between the low and high risk LESS groups on sway index scores on conditions 1 (U = 158.5, p = 0.39), 2 (U = 156.0, p = 0.36), 3 (U = 165.5, p = 0.51), or 4 (U = 128.5, p = 0.08), as well as overall m-CTSIB scores (U = 150.5, p = 0.28).ConclusionsThere appears to be a lack of relationship between the LESS and m-CTSIB tests, revealing the independence of static and dynamic lower extremity neuromuscular function. Athletes who may be more at risk for ACL injury due to abnormal jump-landing biomechanics, do not differ from low-risk athletes on baseline balance assessment.

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Anterior Cruciate Ligament Injury

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967114s00250 ◽

2014 ◽

Vol 2 (12_suppl4) ◽

pp. 2325967114S0025

Author(s):

Tomas Vilaseca ◽

Jorge Chahla ◽

Gustavo Gomez Rodriguez ◽

Damián Arroquy ◽

Gonzalo Perez Herrera ◽

...

Keyword(s):

Anterior Cruciate Ligament ◽

Internal Rotation ◽

Cruciate Ligament ◽

Acl Injury ◽

T Test ◽

Control Group ◽

Recreational Athletes ◽

Significant Difference ◽

Anterior Cruciate ◽

Knee Pathology

Objectives: The objective of this study was to analyze whether it is more frequent the presence of a decreased range of motion in the hips of recreational athletes with primary injury of the anterior cruciate ligament (ACL) than in a control group of volunteers without knee pathology. Methods: We included prospectively recreational athletes between 18 and 40 years with an acute ACL injury between January 2011 and January 2013. They were compared with a control group of volunteers recreational athletes without lower limb pathology and in the same range of age. The internal and external rotations passively prior to the point at which the pelvis movement contributes were observed. The results were statistically analyzed using t test for related samples to the hips of patients with ACL injury and t test for independent variables for comparison with the control group. Results: 48 patients with ACL injury and 53 healthy volunteers were evaluated. The ACL group was composed of 32 males and 16 females with an average age of 29.3 years. In the control group 26 males and 27 females were studied with a mean age of 26.6 years. Internal (IR) and external (ER) rotation in the LCA group was 22,9º and 55,5º respectively in the ipsilateral hip and 27,9º and 57,7º in the contralateral. In the control group a 35,9º of IR and 55,2º of ER was observed. The analysis showed an association between ACL injury and hypomotility of the hip further expense of a decrease in internal rotation. The analysis showed an association between ACL injury and hypomotility of the hip at the expense to a greater decrease in internal rotation. Conclusion: We found a statistically significant difference in the mobility of the hips in patients with ACL injury predominantly due to internal rotation, pattern that allows us to interpret this injury not only as an intrinsic etiology of the knee but also of the adjacent joints. We consider very importance to incorporate prevention activities and screening of risk factors regarding to at least high performance athletes.

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A complex approach in rehabilitation of the patients after the anterior cruciate ligament reconstruction

Health, sport, rehabilitation ◽

10.34142/hsr.2019.05.03.04 ◽

2019 ◽

Vol 5 (3) ◽

pp. 37

Author(s):

I.Ya Hrubar ◽

Yu.O. Hrubar ◽

N.M. Grabyk

Keyword(s):

Anterior Cruciate Ligament ◽

Anterior Cruciate Ligament Reconstruction ◽

Postoperative Period ◽

Ligament Reconstruction ◽

Clinical Course ◽

Cruciate Ligament ◽

Control Group ◽

Cruciate Ligament Reconstruction ◽

Anterior Cruciate ◽

Experimental Group

The Purpose was to improve the treatment outcomes of patients who undergo ACL reconstruction under arthroscopic control through a comprehensive approach to their rehabilitation program. Materials and methods. We have implemented a system of comprehensive rehabilitation of patients after the ACL reconstruction under arthroscopic control, which relied on the phase of the clinical course of the postoperative period.Results. The study involved 40 patients who underwent anterior cruciate ligament reconstruction under arthroscopic control. Experimental group (20 people) who applied a comprehensive approach in rehabilitation after ACL reconstruction, taking into account the phase of the clinical course of the postoperative period. The second group was the control group (20 patients) in which rehabilitation was carried out under the existing program. The use of cryotherapy with adjustable pulse compression in patients of the experimental group from the first day allowed to reduce twice the use of non-narcotic analgesics. Analyzing the dynamics of flexion in the knee joint, it was found that patients of the experimental group on the 25th day performed flexion by 88.46% of the appropriate maximum. Whereas in the control group just - 69.23%. Positive dynamics were noted in the indicators of myotonometry of the quadriceps muscle and measurement of the perimeter of the knee joint.Conclusions. The program of physical rehabilitation of patients after the anterior cruciate ligament reconstruction under arthroscopic control, which was built taking into account the phase of the clinical course of the postoperative period, has been developed and offered positive results in clinical practice. The effectiveness of the program was shown by the improvement of such indicators as: decrease in intensity of pain syndrome in the early postoperative period, increase in the range of motion in the knee joint, faster restoration of the tone of the quadriceps muscle of the thighs of patients of the experimental group as opposed to the control group

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Postural Stability and Responses to Vibrations in Patients After Anterior Cruciate Ligament Surgical Reconstruction

Physiological Research ◽

10.33549/physiolres.933437 ◽

2016 ◽

pp. S409-S416 ◽

Cited By ~ 3

Author(s):

Z. HIRJAKOVÁ ◽

H. ŠINGLIAROVÁ ◽

D. BZDÚŠKOVÁ ◽

J. KIMIJANOVÁ ◽

K. BUČKOVÁ ◽

...

Keyword(s):

Anterior Cruciate Ligament ◽

Postural Stability ◽

Cruciate Ligament ◽

Quadriceps Femoris ◽

Triceps Surae ◽

Surgical Reconstruction ◽

Eyes Closed ◽

Postural Changes ◽

Eyes Open ◽

Anterior Cruciate

The aim of the study was to evaluate the effect of surgical reconstruction of anterior cruciate ligament (ACL) on postural stability and responses to lower limb (LL) muscles vibrations. Centre of pressure (CoP) was measured in 17 subjects during stance on firm/foam surface with eyes open/closed and during unilateral vibrations of LL muscles (m. triceps surae – TS, m. quadriceps femoris – Q, m. quadriceps femoris and hamstrings simultaneously – QH). The measurements were performed: 1) preoperatively, 2) six weeks and 3) three months after the reconstruction. Decreased postural stability was documented six weeks after the reconstruction compared to preoperative measurement. Three months after the reconstruction significant improvement was observed during stance on foam surface with eyes closed. Preoperatively, altered reactions of LL with ACL lesion compared to intact LL were manifested by slower response in first 3 s of TS vibration and by increased CoP shift in last 5 s of QH vibration. After the reconstruction, we observed slower CoP reaction and decreased CoP shift during TS vibration of LL with ACL lesion compared to preoperative level. Posturography during quiet stance and during TS vibration reliably detect postural changes due to ACL reconstruction and can be potentially useful in clinical practice.

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Effectiveness of platelet-rich plasma in the treatment of anterior cruciate ligament injuries: A Systematic Review and Meta-analysis

10.21203/rs.3.rs-1074595/v1 ◽

2021 ◽

Author(s):

Wenfan Gan ◽

Zheng Xu ◽

Chunmei Wu ◽

Junzhi He

Keyword(s):

Systematic Review ◽

Anterior Cruciate Ligament ◽

Anterior Cruciate Ligament Reconstruction ◽

Ligament Reconstruction ◽

Platelet Rich Plasma ◽

Cruciate Ligament ◽

Meta Analysis ◽

Control Group ◽

Cruciate Ligament Reconstruction ◽

Anterior Cruciate

Abstract Background: Recently, a number of randomized controlled trials (RCTs) have researched the efficacy of anterior cruciate ligament reconstruction (ACLR) combined with platelet-rich plasma (PRP) in the treatment of anterior cruciate ligament (ACL) injuries. Therefore, we updated a systematic review based on these RCTs to evaluate the effects of PRP on knee function and pain with different time.Methods: We searched in PubMed, Embase, Cochrane, Web of Science(WOS), China National Knowledge Infrastructure(CNKI), and WANFANG DATABASE, for human RCTs comparing the efficacy of intraarticular injection with no injection of PRP. Descriptive summaries and quality assessments were performed for all studies included in this meta-analysis. The outcomes of the stydy included the International Knee Documentation Committee (IKDC), Visual Analogue Scale (VAS), and Lysholm score.Results: Finally, we included 6 RCTs stydies, involving 315 patients. The control group consisted of blank group or placebo group. Follow-up periods ranged from 3 to 18 months. The results of bias risk assessment showed that all the 6 stuydies are unclear risk of bias. Compared with the control group, PRP group significantly improved IKDC score at 3, 6 and 12 months after operation (P = 0.00, 0.01, respectively). Lysholm score and VAS score also has significant differences at 3 months after operation (both P = 0.00).Conclusion: Our study has proved that PRP was more effective in the recovery of knee function and early pain relief after the ACLR than the ACLR alone. Review registration: PROSPERO CRD42021224182. Registered 6 April 2021. Keywords:anterior cruciate ligament injury; anterior cruciate ligament reconstruction; platelet rich plasma; system review; META analysisReview registration: PROSPERO CRD42021224182. Registered 6 April 2021.

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Between-Limb Differences in Patellofemoral Joint Forces During Running at 12 to 24 Months After Unilateral Anterior Cruciate Ligament Reconstruction

The American Journal of Sports Medicine ◽

10.1177/0363546520914628 ◽

2020 ◽

Vol 48 (7) ◽

pp. 1711-1719 ◽

Cited By ~ 2

Author(s):

Prasanna Sritharan ◽

Anthony G. Schache ◽

Adam G. Culvenor ◽

Luke G. Perraton ◽

Adam L. Bryant ◽

...

Keyword(s):

Anterior Cruciate Ligament ◽

Anterior Cruciate Ligament Reconstruction ◽

Contact Force ◽

Patellofemoral Joint ◽

Ligament Reconstruction ◽

Center Of Pressure ◽

Cruciate Ligament ◽

Knee Extension ◽

Cruciate Ligament Reconstruction ◽

Anterior Cruciate

Background: Patellofemoral joint (PFJ) osteoarthritis may occur after anterior cruciate ligament reconstruction (ACLR). The mechanisms underpinning the development of PFJ osteoarthritis are not known but may relate to altered PFJ loading. Few studies have assessed PFJ loads during high-impact tasks, such as running, beyond the acute rehabilitation phase (ie, >12 months) after ACLR. Purpose/Hypothesis: The purpose was to compare between-limb joint angles, joint moments, and PFJ contact force during running in individuals at 12 to 24 months after unilateral ACLR. We hypothesized that peak knee flexion angle, knee extension moment, and PFJ contact force during stance would be lower in the ACLR limb compared with the uninjured limb. Study Design: Controlled laboratory study. Methods: A total of 55 participants (mean ± SD age, 28 ± 7 years), 12 to 24 months after ACLR, ran at a self-selected speed (2.9 ± 0.3 m/s). Measured kinematics and ground-reaction forces were input into musculoskeletal models to calculate joint moments and muscle forces. These values were subsequently input into a PFJ model to calculate contact force peak and impulse. Outcome measures were compared between the ACLR and uninjured limbs. Results: In the ACLR limb, compared with the uninjured limb, the PFJ contact force displayed a lower peak (ACLR, 6.1 ± 1.3 body weight [BW]; uninjured, 6.7 ± 1.4 BW; P < .001) and impulse (ACLR, 0.72 ± 0.17 BW*seconds [BWs]; uninjured, 0.81 ± 0.17 BWs; P < .001). At the time of the peak PFJ contact force, the knee extension moment was lower in the ACLR limb (ACLR, 14.0 ± 2.4 %BW*height [%BW*HT]; uninjured, 15.5 ± 2.5 %BW*HT; P < .001). The opposite was true for the ankle plantarflexion moment (ACLR, 12.1 ± 2.6 %BW*HT; uninjured, 11.5 ± 2.7 %BW*HT; P = .019) and the hip extension moment (ACLR, 2.3 ± 2.5 %BW*HT; uninjured, 1.6 ± 2.3 %BW*HT; P = .013). The foot-ground center of pressure was located more anteriorly with respect to the ankle joint center (ACLR, 5.8 ± 0.9 %height [%HT]; uninjured, 5.4 ± 1.0 %HT; P = .001). No differences were found for the sagittal plane hip, knee, and ankle angles. Conclusion: The ACLR limb experienced lower peak PFJ loads during running, explained by a small anterior shift in the foot-ground center of pressure during stance that offloaded the torque demand away from the ACLR knee. Clinical Relevance: Lower net PFJ loading during running in the ACLR limb more than 12 months after ACLR suggests that underloading might play a role in the onset of PFJ osteoarthritis after ACLR.

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