The Association Between Gait Biomechanical Profile Clusters and Patient-Reported Outcomes at 6 Months Following an Anterior Cruciate Ligament Reconstruction (2023)
Undergraduate: Erin Carico
Faculty Advisor: Brian Pietrosimone
Department: Exercise and Sport Science
Background: Anterior cruciate ligament reconstruction (ACLR) patients report worse quality of life in comparison to uninjured controls. Non-modifiable risk factors at time of ACL injury (i.e. female sex, greater body mass index, greater age) and mechanobiological factors (i.e. poor gait biomechanical profiles, worse cartilage composition, and low physical activity levels) are uniquely associated with worse patient reported outcomes (PROs) following ACLR. All factors have been assessed in isolation or in small groups; however, it is unknown which factors best identify subgroups of ACLR patients with unique clinical needs. Purpose: The study purpose was to (1) identify subgroups of ACLR subjects within a longitudinal cohort that exhibit similar characteristics and (2) determine between-group differences in PROs at 6 months based on identified subgroups. Methods: Participants were clustered into groups using a K-Means cluster analysis using all available data (i.e. demographics, gait biomechanics, cartilage composition estimates, and physical activity) from an ongoing longitudinal cohort at preoperative, two, four, and six- months post-ACLR timepoints. Between-group differences in the Knee Osteoarthritis Outcomes score (KOOS) subscales were assessed with independent t-tests. Results: Gait biomechanical variables, specifically variables assessing loading magnitude, were most influential in separating the cohort (n=61) into two distinct clusters (Pseudo F=6.91). No statistically significant between-group differences in KOOS subscales were found (p>0.05). Conclusion: Gait biomechanical profiles best identify subgroups of ACLR patients; however, both groups report low PROs at 6 months post-ACLR. Personalized interventions should be developed to optimize clinical outcomes following ACLR.
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