Correlation between gait analysis parameters and joint function prognosis during rehabilitation after anterior cruciate ligament reconstruction: a retrospective study

Abstract

OBJECTIVE: To evaluate changes in gait parameters following autograft hamstring anterior cruciate ligament (ACL) reconstruction and their association with knee function recovery and to explore the predictive value of gait parameters in clinical assessment. METHODS: A total of 186 patients who underwent ACL reconstruction between January 2020 and September 2023 were enrolled. Gait analysis and knee function assessments (Lysholm, International Knee Documentation Committee [IKDC], and Tegner scores) were performed pre- and postoperatively. Gait data were collected using the Sennotech Insole X 1.0 system. Multivariate linear regression and logistic regression models identified significant gait predictors, and function prediction models were constructed and evaluated using Receiver Operating Characteristic (ROC) curves and decision curve analysis (DCA). RESULTS: Postoperative gait parameters significantly improved, particularly stride length, step height, and landing impact force (all P < 0.05). Knee function scores, including Lysholm and IKDC, significantly improved, while the Tegner score declined (all P < 0.001). Stride length was positively correlated with Lysholm and IKDC scores, while impact force was negatively correlated with IKDC. Multivariate regression analysis identified stride length and lift angle as significant predictors of Lysholm and IKDC scores, while flat phase and impact force were negatively associated with Tegner score. The predictive model demonstrated AUC values of 0.73 and 0.66 for the training and testing sets, respectively. DCA confirmed the clinical utility of the model. CONCLUSION: Gait improvements following ACL reconstruction are closely linked to knee function recovery. Key gait parameters serve as objective predictors and can guide personalized rehabilitation planning.