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The effect of anterior cruciate ligament reconstruction on stride-to-stride variability.

Moraiti CO, Stergiou N, Ristanis S, Vasiliadis HS, Patras K, Lee C, Georgoulis AD.

Arthroscopy. 2009 Jul;25(7):742-9.

PURPOSE: The purpose of our study was to investigate the functional outcome after anterior cruciate ligament (ACL) reconstruction using bone-patellar tendon-bone (BPTB) and quadrupled semitendinosus and gracilis tendon (ST/G) autografts by evaluating stride-to-stride variability. METHODS: Six patients with BPTB and 6 patients with STG ACL reconstruction, 2 years postoperatively, and 6 healthy control subjects walked on a treadmill at a self-selected pace while 2 minutes of continuous kinematic data were recorded with a 6-camera optoelectronic system. Stride-to-stride variability was calculated from the knee flexion/extension data using the nonlinear measure of approximate entropy, which estimates the regularity of movement patterns over time. RESULTS: ACL reconstruction affects stride-to-stride variability. Both the BPTB and the ST/G groups had significantly larger approximate entropy values than the healthy controls. No differences were found between the BPTB and the ST/G approximate entropy values. CONCLUSIONS: After ACL reconstruction using either BPTB or quadrupled ST/G, there is increased gait variability as compared to healthy individuals. This could be caused by the altered neuromuscular activity found in ACL-reconstructed limbs. LEVEL OF EVIDENCE: Level III, case control study.