Do gait biomechanics have importance in OA onset in ACL-reconstructed knees?

Gait mechanics after ACL reconstruction: implications for the early onset of knee osteoarthritis. 
Butler, R., Minick, K., Ferber, R., Underwood, F. British Journal of Sports Medicine, 2009; 43, 366–370.
http://www.ncbi.nlm.nih.gov/pubmed/19042923

Individuals with anterior cruciate ligament reconstruction might be at increased risk to develop knee osteoarthritis. The mechanism behind the early onset of knee OA in individuals who have sustained an ACL injury is not fully investigated. It has been suggested that factors related to gait mechanics might be associated with early knee OA progression.  The increased frontal plane moment at the knee has been suggested to promote degradation of the medial tibiofemoral compartment of the knee, however lack of research is present analyzing this variable in ACL – reconstructed knees. The aim of this study was to examine the internal knee moments and knee joint angles in individuals who have undergone ACL reconstruction compared with a group of matched controls with no history of knee injury.
17 subjects (13 women, 4 men) with a previous ACL reconstruction were recruited for the study along with a matched control group. All participants underwent gait analysis at an intentional walking speed to examine variables of interest. Study found that Individuals in the ACL group exhibited a 21% larger peak knee-abduction moment than the control group, which was significantly different. No significant differences were seen for the peak frontal plane moments at the hip and peak adduction or adduction excursion at the knee or hip.
Considering the findings of the study, we can suppose that an increased peak knee-abduction moment in subjects with ACL reconstruction might be one potential mechanism behind the early development of knee OA. In light of the findings of this study, it seems that interventions that can reduce the peak knee-abduction moment should be implemented into the rehabilitation programmes for patients after ACL reconstruction to decrease the risk of early knee OA onset. Authors suggest that an initial gait analysis after ACL surgery may be utilized to detect the compartment of the tibiofemoral joint that is at greater risk for the development of knee OA. Information obtained, would be useful in guiding the design of any conservative mechanical interventions, such as wedged foot orthoses and knee bracing that addresses knee malalignment and has been shown to reduce symptoms in people with knee OA.
Do you implement intervention to address knee malalignment for patients after knee reconstruction? And do you think that these interventions would be beneficial for those patients to use in pre – operative state?
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