Changes and Compensatory Gait Mechanisms in Lower Extremity Kinematics in Patients With ACL Rupture: A Cross-sectional Controlled Study.

Sports Health · Sep 11 2026 · Recent

Zhao X, Wu D, Wang S, Theobald P

School of Engineering, Cardiff University, Cardiff, UK

Sports Medicine

SUMMARY — THE REDUCTIONPatients with ACL rupture showed bilateral gait changes—reduced hip external rotation/adduction and ankle internal rotation plus lower affected-side knee flexion—supporting rehab that addresses both limbs.
Abstract, as published

BACKGROUND: Anterior cruciate ligament (ACL) rupture is associated with knee instability and compensatory gait adaptations, which are relevant to rehabilitation planning.

HYPOTHESIS: Patients with ACL rupture would show altered bilateral hip, knee, and ankle gait kinematics.

METHODS: A total of 40 participants were enrolled, including 22 patients with recent ACL ruptures and 18 healthy subjects. Participants walked on a treadmill at 4 km/h while wearing 17 inertial sensors. Ten normalized gait cycles were used to compare bilateral hip, knee, and ankle kinematics.

RESULTS: Patients with ACL rupture demonstrated altered lower-extremity kinematics compared with healthy subjects. Hip external rotation was reduced bilaterally (P < 0.01), and hip adduction was reduced on both the affected (P < 0.05) and nonaffected (P < 0.01) sides. Maximum knee flexion was lower on the affected side than in healthy subjects (P < 0.01) and the nonaffected side (P < 0.05). Maximum ankle internal rotation was reduced bilaterally (affected side P < 0.05; nonaffected side P < 0.01), suggesting bilateral gait adaptations after ACL rupture.

CONCLUSION: ACL rupture was associated with gait alterations involving both lower extremities, with bilateral hip and ankle kinematic changes and reduced maximum knee flexion mainly on the affected side.

CLINICAL RELEVANCE: Recognition of bilateral kinematic changes after ACL rupture may help clinicians assess both limbs and guide rehabilitation focused on restoring functional gait patterns.

STUDY DESIGN: Cross-sectional study.

LEVEL OF EVIDENCE: Level 3.

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