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Piri E, Jafarnezhadgero A. Walking and Running Mechanics After Anterior Cruciate Ligament Reconstruction: An Editorial Review. PTJ 2026; 16 (2) :127-132
URL: http://ptj.uswr.ac.ir/article-1-804-en.html

Purpose: This editorial review aims to synthesize current evidence on walking and running biomechanics following anterior cruciate ligament (ACL) reconstruction, with a specific focus on recovery patterns at 6, 12, and 18 months post‑surgery. The goal is to highlight temporal changes in spatiotemporal, kinematic, kinetic, and neuromuscular variables that influence functional recovery, return-to-sport readiness, and long‑term joint health.
Methods: Relevant peer‑reviewed studies published in recent years were analyzed, including longitudinal, cross‑sectional, and meta‑analytic research investigating gait and running mechanics after ACL reconstruction. Data from biomechanical assessments such as 3D motion analysis, force‑plate evaluations, muscle activation studies, and strength testing were synthesized to identify key recovery trends across the three time points.
Results: At 6 months post-surgery, pronounced asymmetries in walking and running mechanics persist, including reduced knee flexion, lower knee extensor moments, diminished power generation, and neuromuscular inhibition of the quadriceps. By 12 months, walking mechanics show partial normalization; however, significant deficits in running particularly in knee abduction moments, loading symmetry, and hip control remain in many patients. At 18 months, most walking parameters approach normal values, while subtle running asymmetries may still persist in tasks requiring higher neuromuscular demand. Continued neuromuscular training beyond 12 months appears to enhance recovery and reduce reinjury risk.
Conclusion: Biomechanical recovery after ACL reconstruction progresses beyond traditional 9–12 month timelines, with running mechanics showing greater sensitivity to persistent deficits than walking. Recognizing these delayed recovery patterns is essential for improving rehabilitation strategies, optimizing return‑to‑sport decisions, and minimizing long‑term joint degeneration. Extended, individualized rehabilitation and objective biomechanical assessment are recommended to better support functional and structural recovery.