Factors associated with dynamic knee valgus angle during single-leg forward landing in patients after anterior cruciate ligament reconstruction

Abstract

A few studies have reported on how to predict increased dynamic knee valgus angle (KVA), a risk factor for second anterior cruciate ligament (ACL) injury after ACL reconstruction. This study aimed to identify the factors with the potential to predict the KVA during single-leg hop landing. Using three-dimensional motion analysis systems, knee motion during a single-leg hop landing task was measured in 22 patients who had undergone ACL reconstruction at 8–10 months postoperatively. The KVA at initial contact (IC) and maximum KVA during the 40-ms period after IC were calculated using the point cluster technique; correlations between the KVA and other factors were assessed. We performed multiple regression analysis to determine whether KVA could be predicted by these parameters. The KVA was significantly negatively correlated with the static femorotibial angle (FTA; P < 0.01) and patient height (P < 0.01). It was positively correlated with the body mass index (P < 0.05). Multiple regression analysis showed that a small FTA could predict the KVA at IC (β: 0.52, 95% confidence interval (CI): 2.24-(-0.42); P < 0.01). The maximum KVA during the 40-ms period after IC was associated with the FTA (β: 0.46, 95% CI: 2.22-(-0.26); P = 0.02) and height (β: 0.40, 95% CI: 0.59-(-0.02); P = 0.04). At 8–10 months after ACL reconstruction, the KVA was significantly correlated with the FTA, with reduced FTA being associated with an increased dynamic KVA during single-leg hop landing. The measurement of anatomical parameters may aid in predicting the second ACL injury risk after reconstruction.