Functional evaluation of the knee following ACL reconstruction: A complex dynamical systems perspective
Keywords:
Anterior cruciate ligament, Complex dynamical systems theory, Kinematic variability, Motion analysis, , Nonlinear analysisAbstract
In sports, anterior cruciate ligament (ACL) injuries are very frequent and, in most cases, it is necessary to resort to surgical reconstruction to restore the functionality and stability of the knee joint. For the experts, the fundamental clinical result is represented by the return to sport at the pre-injury level. Return to the sport, however, is complex and multifactorial. A functional asymmetry present after the resumption of sports activity is, in fact, a sign of a reduced ability of the knee to absorb dynamic forces. The dynamical systems theory (DST) applied to biological systems has emphasized the importance of the variability present in human movement, as a basis for the processes of adaptation to the surrounding environment. The human body is a complex and nonlinear system (a small input can produce a big change), therefore nonlinear analysis tools have been proposed to analyse its behaviour. This brief review provides an overview of the nonlinear analysis tools used in the past twenty years in the functional evaluation of the knee following ACL reconstruction. The analysis of kinematic variability of the knee provides important information on the changes in neuromuscular function that occur after the rupture and reconstruction of the ACL. This kind of analysis can lead to an understanding of the joint's ability to provide proprioceptive information and how the whole system processes them. The functional evaluation of the knee using nonlinear analysis tools could represent a new and more suitable functional measurement of the joint for the return to sport.
Funding
University of SalernoDownloads
References
Berchuck M., Andriacchi T.P., Bach B.R., Reider B. (1990). Gait adaptations by patients who have a deficient anterior cruciate ligament. The Journal of Bone and Joint Surgery. https://doi.org/10.2106/00004623-199072060-00012
Davids K., Hristovski R., Araúio D., Balagué Serre N., Button C., Passos P. (2014). Complex Systems in Sport. Routledge.
Decker L.M., Moraiti C., Stergiou N., Georgoulis A.D. (2011). New insights into anterior cruciate ligament deficiency and reconstruction through the assessment of knee kinematic variability in terms of nonlinear dynamics. Springer-Verlag. https://doi.org/10.1007/s00167-011-1484-2
De Oliveira E.A., Andrade A.O., Vieira M.F. (2019). Linear and nonlinear measures of gait variability after anterior cruciate ligament reconstruction. Journal of Electromyography and Kinesiology. https://doi.org/10.1016/j.jelekin.2019.03.007
Dingwell S., Cusumano J.P., Cavanagh P.R., Sternad D. (2001). Local dynamic stability versus kinematic variability of continuous overground and treadmill walking. Journal of Biomechanical Engineering. https://doi.org/10.1115/1.1336798
Ferber R, Osternig LR, Woollacott MH, Wasielewski NJ, Lee JH. (2004). Bilateral accommodations to anterior cruciate ligament deficiency and surgery. ClinBiomech. https://doi.org/10.1016/j.clinbiomech.2003.10.008
Georgoulis A.D., Moraiti C., Ristains S., Stregiou N. (2006). A novel approach to measure variability in the anterior cruciate ligament deficient knee during walking: the use of approximate entropy in orthopaedics. Journal of Clinical Monitoring and Computing. https://doi.org/10.1007/s10877-006-1032-7
Lanier A.S., Knarr B.A., Stergiou N., Snyer-Mackier L., Buchanan T. (2020). ACL injury and reconstruction affect control of ground reactions forces produced during a novel task that simulates cutting movements. Journal of Orthopaedic Research. https://doi.org/10.1002/jor.24604
Matsas A., Taylor n., McBurney H. (2000). Knee joint kinematics from familiarised treadmill walking in young unimpaired subjects. Elsevier.
Moraiti C., Stergiou N., Ristains S., Georgoulis A.D. (2007). ACL deficiency affects stride-to-stride variability as measured using nonlinear methodology. Springer-Verlag. https://doi.org/10.1007/s00167-007-0373-1
Moraiti C., Stegiou N., Ristains S., Vasiliadis H.S., Patras K., Lee C. Georgoulis A.D. (2009). The effect of anterior cruciate ligament reconstruction on stride-to-stride variability. Arthroscopy: The Journal of Arthroscopic and Related Surgery. https://doi.org/10.1016/j.arthro.2009.01.016
Moraiti C., Stengiou N., Vasiliadis H.S., Motsis E., Georgoulis A.D. (2010). Anterior cruciate ligament reconstruction results in alterations in gait variability. Gait &Posture. https://doi.org/10.1016/j.gaitpost.2010.04.008
Stergiou N., Moraiti C., Giakas G., Ristanis S., Georgoulis A.D. (2004). The effect of the walking speed on the stability of the anterior cruciate ligament deficient knee. Clinical Biomechanics. https://doi.org/10.1016/j.clinbiomech.2004.06.008
Skurvydas A., Masiulis N., Rimtautas G., Dargevičiüte G., Parulytê D., Trumpickas V., Kaiesiniskas J.R. (2011). Extension and flexion torque variability in ACL deficiency. Springer-Varleg. https://doi.org/10.1007/s00167-011-1425-0
Zampeli F., Moraiti C., Xergia S., Tsiaras V.A., Stengiou N., Georgoulis A.D. (2010). Stride-to-stride variability is altered during backward walking in anterior cruciate ligament deficient patients. Clinical Biomechanics. https://doi.org/10.1016/j.clinbiomech.2010.07.015
Published
How to Cite
Issue
Section
License
Copyright (c) 2020 Journal of Human Sport and Exercise
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Each author warrants that his or her submission to the Work is original and that he or she has full power to enter into this agreement. Neither this Work nor a similar work has been published elsewhere in any language nor shall be submitted for publication elsewhere while under consideration by JHSE. Each author also accepts that the JHSE will not be held legally responsible for any claims of compensation.
Authors wishing to include figures or text passages that have already been published elsewhere are required to obtain permission from the copyright holder(s) and to include evidence that such permission has been granted when submitting their papers. Any material received without such evidence will be assumed to originate from the authors.
Please include at the end of the acknowledgements a declaration that the experiments comply with the current laws of the country in which they were performed. The editors reserve the right to reject manuscripts that do not comply with the abovementioned requirements. The author(s) will be held responsible for false statements or failure to fulfill the above-mentioned requirements.
This title is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International license (CC BY-NC-ND 4.0).
You are free to share, copy and redistribute the material in any medium or format. The licensor cannot revoke these freedoms as long as you follow the license terms under the following terms:
Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
NonCommercial — You may not use the material for commercial purposes.
NoDerivatives — If you remix, transform, or build upon the material, you may not distribute the modified material.
No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.
Notices:
You do not have to comply with the license for elements of the material in the public domain or where your use is permitted by an applicable exception or limitation.
No warranties are given. The license may not give you all of the permissions necessary for your intended use. For example, other rights such as publicity, privacy, or moral rights may limit how you use the material.
Transfer of Copyright
In consideration of JHSE’s publication of the Work, the authors hereby transfer, assign, and otherwise convey all copyright ownership worldwide, in all languages, and in all forms of media now or hereafter known, including electronic media such as CD-ROM, Internet, and Intranet, to JHSE. If JHSE should decide for any reason not to publish an author’s submission to the Work, JHSE shall give prompt notice of its decision to the corresponding author, this agreement shall terminate, and neither the author nor JHSE shall be under any further liability or obligation.
Each author certifies that he or she has no commercial associations (e.g., consultancies, stock ownership, equity interest, patent/licensing arrangements, etc.) that might pose a conflict of interest in connection with the submitted article, except as disclosed on a separate attachment. All funding sources supporting the Work and all institutional or corporate affiliations of the authors are acknowledged in a footnote in the Work.
Each author certifies that his or her institution has approved the protocol for any investigation involving humans or animals and that all experimentation was conducted in conformity with ethical and humane principles of research.
Competing Interests
Biomedical journals typically require authors and reviewers to declare if they have any competing interests with regard to their research.
JHSE require authors to agree to Copyright Notice as part of the submission process.