Dynamic Knee Stability and Movement Strategy During a Forward Lunge After Anterior Cruciate Ligament Reconstruction: A Comparison of Individuals With and Without Knee Pain

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Abstract
Individuals with anterior cruciate ligament reconstruction and knee pain (symptomatic) have demonstrated reduced knee extensor strength and similar knee joint loading during a forward lunge (FL) as compared with those without pain (asymptomatic) 3–10 years after anterior cruciate ligament reconstruction. Still, the dynamic knee joint stability during FL may differ between the groups. This study examined dynamic knee stability, measured by knee wobble through 3D kinematic modeling, to explore if symptomatic individuals exhibit more mediolateral knee wobble than asymptomatic individuals. Additionally, kinematic and kinetic movement strategy differences between the groups were investigated. Musculoskeletal modeling of the FL was applied to quantify knee wobble and other biomechanical parameters. In total, 33 symptomatic and 89 asymptomatic participants were included. No significant difference in knee wobble was observed between groups (mean difference: −0.16 [95% CI, −0.61 to 0.29], P = .480). Overall, only negligible between-group movement pattern differences were observed, most notably, the symptomatic group exhibited less concentric knee work (mean difference: 0.16 J/kg [95% CI, 0.04 to 0.28], P = .012) compared to the asymptomatic group. These findings suggest that symptomatic and asymptomatic individuals exhibit similar dynamic knee stability and movement strategies during the FL, 3–10 years after anterior cruciate ligament reconstruction.

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