Skip to main content
Top
Published in: Knee Surgery, Sports Traumatology, Arthroscopy 6/2020

01-06-2020 | Knee

Anterior cruciate ligament reconstructed females who pass or fail a functional test battery do not exhibit differences in knee joint landing biomechanics asymmetry before and after exercise

Authors: Eunwook Chang, Samuel T. Johnson, Christine D. Pollard, Mark A. Hoffman, Marc F. Norcross

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 6/2020

Login to get access

Abstract

Purpose

A functional test battery (FTB) has been proposed to evaluate the readiness of return to activity after ACLR. However, there is limited evidence documenting the usefulness of an FTB. Therefore, the purpose of the current investigation was to compare knee joint landing biomechanics asymmetry during double-leg jump landing (DLJL) and single-leg jump cutting (SLJC) between healthy females and ACLR females who pass (ACLR-pass) or fail (ACLR-fail) an FTB before and after the completion of a sustained exercise protocol.

Method

Eighteen ACLR females (ten ACLR-pass and eight ACLR-fail) and twelve healthy females performed an FTB including The 2000 International Knee Documentation Committee Subjective Knee Evaluation Form, the Knee Outcome Survey Activities of Daily Living Scale, quadriceps strength, and single-leg hop tests. DLJL and SLJC knee joint biomechanics asymmetry were measured before and after exercise.

Results

During DLJL, there were significant main effects of group on peak anterior tibial shear force (ATSF) asymmetry [F(2,27) = 3.86, p < 0.05, \(\eta_{{\text{p}}}^{2}\) = 0.214] and peak vertical ground reaction force (vGRF) asymmetry [F(2,27) = 3.34, p = 0.05, \(\eta_{{\text{p}}}^{2}\) = 0.198]. During SLJC, there was a significant group main effect for peak ATSF asymmetry [F(2,27) = 3.494, p = 0.04, \(\eta_{{\text{p}}}^{2}\) = 0.206].

Conclusion

ACLR-fail exhibited greater asymmetry in peak ATSF during DLJL and SLJC compared to healthy females. In addition, ACLR-pass exhibited greater asymmetry in peak ATSF and peak vGRF during DLJL and SLJC, respectively, compared to healthy females. However, ACLR-fail did not exhibit any significant differences in landing biomechanics asymmetry during either task compared with ACLR-pass. Furthermore, the completion of a sustained exercise protocol did not affect knee joint landing biomechanics asymmetry across groups.

Level of evidence

II.
Literature
1.
go back to reference Bell D, Kulow S, Pennuto A, Stiffler M (2014) Squatting mechanics between ACL—reconstructed patients who pass and fail return-to-sport criteria. J Athl Train 49:S-237 Bell D, Kulow S, Pennuto A, Stiffler M (2014) Squatting mechanics between ACL—reconstructed patients who pass and fail return-to-sport criteria. J Athl Train 49:S-237
2.
go back to reference Bisseling RW, Hof AL (2006) Handling of impact forces in inverse dynamics. J Biomech 39:2438–2444CrossRefPubMed Bisseling RW, Hof AL (2006) Handling of impact forces in inverse dynamics. J Biomech 39:2438–2444CrossRefPubMed
3.
go back to reference Chang EW, Johnson S, Pollard C, Hoffman M, Norcross M (2018) Landing biomechanics in anterior cruciate ligament reconstructed females who pass or fail a functional test battery. Knee 25:1074–1082CrossRefPubMed Chang EW, Johnson S, Pollard C, Hoffman M, Norcross M (2018) Landing biomechanics in anterior cruciate ligament reconstructed females who pass or fail a functional test battery. Knee 25:1074–1082CrossRefPubMed
4.
go back to reference Chappell JD, Herman DC, Knight BS, Kirkendall DT, Garrett WE, Yu B (2005) Effect of fatigue on knee kinetics and kinematics in stop-jump tasks. Am J Sports Med 33:1022–1029CrossRefPubMed Chappell JD, Herman DC, Knight BS, Kirkendall DT, Garrett WE, Yu B (2005) Effect of fatigue on knee kinetics and kinematics in stop-jump tasks. Am J Sports Med 33:1022–1029CrossRefPubMed
5.
go back to reference Cohen J (1988) Statistical power analysis for the behavioral sciences. Lawrence Erlbaum Associates, Hillsdale Cohen J (1988) Statistical power analysis for the behavioral sciences. Lawrence Erlbaum Associates, Hillsdale
6.
go back to reference Cronin B, Johnson ST, Chang E, Pollard CD, Norcross MF (2016) Greater hip extension but not hip abduction explosive strength is associated with lesser hip adduction and knee valgus motion during a single-leg jump-cut. Orthop J Sports Med 4:1–8CrossRef Cronin B, Johnson ST, Chang E, Pollard CD, Norcross MF (2016) Greater hip extension but not hip abduction explosive strength is associated with lesser hip adduction and knee valgus motion during a single-leg jump-cut. Orthop J Sports Med 4:1–8CrossRef
7.
go back to reference Frank B, Bell DR, Norcross MF, Blackburn JT, Goerger BM, Padua DA (2013) Trunk and hip biomechanics influence anterior cruciate loading mechanisms in physically active participants. Am J Sports Med 41:2678–2683CrossRef Frank B, Bell DR, Norcross MF, Blackburn JT, Goerger BM, Padua DA (2013) Trunk and hip biomechanics influence anterior cruciate loading mechanisms in physically active participants. Am J Sports Med 41:2678–2683CrossRef
8.
go back to reference Frank BS, Gilsdorf CM, Goerger BM, Prentice WE, Padua DA (2014) Neuromuscular fatigue alters postural control and sagittal plane hip biomechanics in active females with anterior cruciate ligament reconstruction. Sports Health 6:301–308PubMedPubMedCentralCrossRef Frank BS, Gilsdorf CM, Goerger BM, Prentice WE, Padua DA (2014) Neuromuscular fatigue alters postural control and sagittal plane hip biomechanics in active females with anterior cruciate ligament reconstruction. Sports Health 6:301–308PubMedPubMedCentralCrossRef
9.
go back to reference Gagnon D, Gagnon M (1992) The influence of dynamic factors on triaxial net muscular moments at the L5S1 joint during asymmetrical lifting and lowering. J Biomech 25:891–901CrossRefPubMed Gagnon D, Gagnon M (1992) The influence of dynamic factors on triaxial net muscular moments at the L5S1 joint during asymmetrical lifting and lowering. J Biomech 25:891–901CrossRefPubMed
10.
go back to reference Goerger BM, Marshall SW, Beutler AI, Blackburn JT, Wilckens JH, Padua DA (2014) Anterior cruciate ligament injury alters preinjury lower extremity biomechanics in the injured and uninjured leg: the JUMP-ACL study. Br J Sports Med 49:188–195CrossRefPubMed Goerger BM, Marshall SW, Beutler AI, Blackburn JT, Wilckens JH, Padua DA (2014) Anterior cruciate ligament injury alters preinjury lower extremity biomechanics in the injured and uninjured leg: the JUMP-ACL study. Br J Sports Med 49:188–195CrossRefPubMed
11.
go back to reference Gokeler A, Hof AL, Arnold MP, Dijkstra PU, Postema K, Otten E (2010) Abnormal landing strategies after ACL reconstruction. Scand J Med Sci Sports 20:e12–e19CrossRefPubMed Gokeler A, Hof AL, Arnold MP, Dijkstra PU, Postema K, Otten E (2010) Abnormal landing strategies after ACL reconstruction. Scand J Med Sci Sports 20:e12–e19CrossRefPubMed
12.
go back to reference Gustavsson A, Neeter C, Thomeé P, Silbernagel KG, Augustsson J, Thomeé R, Karlsson J (2006) A test battery for evaluating hop performance in patients with an ACL injury and patients who have undergone ACL reconstruction. Knee Surg Sports Traumatol Arthrosc 14:778–788CrossRefPubMed Gustavsson A, Neeter C, Thomeé P, Silbernagel KG, Augustsson J, Thomeé R, Karlsson J (2006) A test battery for evaluating hop performance in patients with an ACL injury and patients who have undergone ACL reconstruction. Knee Surg Sports Traumatol Arthrosc 14:778–788CrossRefPubMed
13.
go back to reference Hewett TE, Myer GD, Ford KR, Heidt RS, Colosimo AJ, McLean SG, van den Bogert AJ, Paterno MV, Succop P (2005) Biomechanical measures of neuromuscular control and valgus loading of the knee predict anterior cruciate ligament injury risk in female athletes. A prospective study. Am J Sports Med 33:492–501CrossRefPubMed Hewett TE, Myer GD, Ford KR, Heidt RS, Colosimo AJ, McLean SG, van den Bogert AJ, Paterno MV, Succop P (2005) Biomechanical measures of neuromuscular control and valgus loading of the knee predict anterior cruciate ligament injury risk in female athletes. A prospective study. Am J Sports Med 33:492–501CrossRefPubMed
14.
go back to reference Hoffman M, Schrader J, Applegate T, Koceja D (1998) Unilateral postural control of the functionally dominant and nondominant extremities of healthy subjects. J Athl Train 33:319PubMedPubMedCentral Hoffman M, Schrader J, Applegate T, Koceja D (1998) Unilateral postural control of the functionally dominant and nondominant extremities of healthy subjects. J Athl Train 33:319PubMedPubMedCentral
15.
go back to reference Ithurburn MP, Paterno MV, Ford KR, Hewett TE, Schmitt LC (2015) Young athletes with quadriceps femoris strength asymmetry at return to sport after anterior cruciate ligament reconstruction demonstrate asymmetric single-leg drop-landing mechanics. Am J Sports Med 43:2727–2737CrossRefPubMed Ithurburn MP, Paterno MV, Ford KR, Hewett TE, Schmitt LC (2015) Young athletes with quadriceps femoris strength asymmetry at return to sport after anterior cruciate ligament reconstruction demonstrate asymmetric single-leg drop-landing mechanics. Am J Sports Med 43:2727–2737CrossRefPubMed
16.
go back to reference Johnston PT, McClelland JA, Webster KE (2018) Lower limb biomechanics during single-leg landings following anterior cruciate ligament reconstruction: a systematic review and meta-analysis. Sports Med Auckl N Z 48:2103–2126CrossRef Johnston PT, McClelland JA, Webster KE (2018) Lower limb biomechanics during single-leg landings following anterior cruciate ligament reconstruction: a systematic review and meta-analysis. Sports Med Auckl N Z 48:2103–2126CrossRef
17.
go back to reference Kristianslund E, Krosshaug T, van den Bogert AJ (2012) Effect of low pass filtering on joint moments from inverse dynamics: implications for injury prevention. J Biomech 45:666–671CrossRefPubMed Kristianslund E, Krosshaug T, van den Bogert AJ (2012) Effect of low pass filtering on joint moments from inverse dynamics: implications for injury prevention. J Biomech 45:666–671CrossRefPubMed
18.
go back to reference Logerstedt D, Di Stasi S, Grindem H, Lynch A, Eitzen I, Engebretsen L, Risberg MA, Axe MJ, Snyder-Mackler L (2014) Self-reported knee function can identify athletes who fail return-to-activity criteria up to 1 year after anterior cruciate ligament reconstruction: a Delaware-Oslo ACL cohort study. J Orthop Sports Phys Ther 44:914–923PubMedPubMedCentralCrossRef Logerstedt D, Di Stasi S, Grindem H, Lynch A, Eitzen I, Engebretsen L, Risberg MA, Axe MJ, Snyder-Mackler L (2014) Self-reported knee function can identify athletes who fail return-to-activity criteria up to 1 year after anterior cruciate ligament reconstruction: a Delaware-Oslo ACL cohort study. J Orthop Sports Phys Ther 44:914–923PubMedPubMedCentralCrossRef
19.
go back to reference Logerstedt D, Grindem H, Lynch A, Eitzen I, Engebretsen L, Risberg MA, Axe MJ, Snyder-Mackler L (2012) Single-legged hop tests as predictors of self-reported knee function after anterior cruciate ligament reconstruction: the Delaware-Oslo ACL cohort study. Am J Sports Med 40:2348–2356PubMedPubMedCentralCrossRef Logerstedt D, Grindem H, Lynch A, Eitzen I, Engebretsen L, Risberg MA, Axe MJ, Snyder-Mackler L (2012) Single-legged hop tests as predictors of self-reported knee function after anterior cruciate ligament reconstruction: the Delaware-Oslo ACL cohort study. Am J Sports Med 40:2348–2356PubMedPubMedCentralCrossRef
20.
go back to reference Lucci S, Cortes N, Van Lunen B, Ringleb S, Onate J (2011) Knee and hip sagittal and transverse plane changes after two fatigue protocols. J Sci Med Sport 14:453–459PubMedPubMedCentralCrossRef Lucci S, Cortes N, Van Lunen B, Ringleb S, Onate J (2011) Knee and hip sagittal and transverse plane changes after two fatigue protocols. J Sci Med Sport 14:453–459PubMedPubMedCentralCrossRef
21.
go back to reference McLean SG, Samorezov JE (2009) Fatigue-induced ACL injury risk stems from a degradation in central control. Med Sci Sports Exerc 41:1661–1672PubMed McLean SG, Samorezov JE (2009) Fatigue-induced ACL injury risk stems from a degradation in central control. Med Sci Sports Exerc 41:1661–1672PubMed
22.
go back to reference Neeter C, Gustavsson A, Thomeé P, Augustsson J, Thomeé R, Karlsson J (2006) Development of a strength test battery for evaluating leg muscle power after anterior cruciate ligament injury and reconstruction. Knee Surg Sports Traumatol Arthrosc 14:571–580CrossRefPubMed Neeter C, Gustavsson A, Thomeé P, Augustsson J, Thomeé R, Karlsson J (2006) Development of a strength test battery for evaluating leg muscle power after anterior cruciate ligament injury and reconstruction. Knee Surg Sports Traumatol Arthrosc 14:571–580CrossRefPubMed
23.
go back to reference Norcross MF, Lewek MD, Padua DA, Shultz SJ, Weinhold PS, Blackburn JT (2013) Lower extremity energy absorption and biomechanics during landing, part I: sagittal-plane energy absorption analyses. J Athl Train 48:748–756PubMedPubMedCentralCrossRef Norcross MF, Lewek MD, Padua DA, Shultz SJ, Weinhold PS, Blackburn JT (2013) Lower extremity energy absorption and biomechanics during landing, part I: sagittal-plane energy absorption analyses. J Athl Train 48:748–756PubMedPubMedCentralCrossRef
24.
go back to reference Oberländer KD, Brüggemann G-P, Hoeher J, Karamanidis K (2013) Altered landing mechanics in ACL-reconstructed patients. Med Sci Sports Exerc 45:506–513CrossRefPubMed Oberländer KD, Brüggemann G-P, Hoeher J, Karamanidis K (2013) Altered landing mechanics in ACL-reconstructed patients. Med Sci Sports Exerc 45:506–513CrossRefPubMed
25.
go back to reference Oberländer KD, Brüggemann G-P, Höher J, Karamanidis K (2014) Knee mechanics during landing in anterior cruciate ligament patients: a longitudinal study from pre- to 12 months post-reconstruction. Clin Biomech Bristol Avon 29:512–517CrossRef Oberländer KD, Brüggemann G-P, Höher J, Karamanidis K (2014) Knee mechanics during landing in anterior cruciate ligament patients: a longitudinal study from pre- to 12 months post-reconstruction. Clin Biomech Bristol Avon 29:512–517CrossRef
26.
go back to reference Palmieri-Smith RM, Lepley LK (2015) Quadriceps strength asymmetry after anterior cruciate ligament reconstruction alters knee joint biomechanics and functional performance at time of return to activity. Am J Sports Med 43:1662–1669PubMedPubMedCentralCrossRef Palmieri-Smith RM, Lepley LK (2015) Quadriceps strength asymmetry after anterior cruciate ligament reconstruction alters knee joint biomechanics and functional performance at time of return to activity. Am J Sports Med 43:1662–1669PubMedPubMedCentralCrossRef
27.
go back to reference Paterno MV, Ford KR, Myer GD, Heyl R, Hewett TE (2007) Limb asymmetries in landing and jumping 2 years following anterior cruciate ligament reconstruction. Clin J Sport Med 17:258–262CrossRefPubMed Paterno MV, Ford KR, Myer GD, Heyl R, Hewett TE (2007) Limb asymmetries in landing and jumping 2 years following anterior cruciate ligament reconstruction. Clin J Sport Med 17:258–262CrossRefPubMed
28.
go back to reference Paterno MV, Rauh MJ, Schmitt LC, Ford KR, Hewett TE (2012) Incidence of contralateral and ipsilateral anterior cruciate ligament (ACL) injury after primary ACL reconstruction and return to sport. Clin J Sport Med 22:116–121PubMedPubMedCentralCrossRef Paterno MV, Rauh MJ, Schmitt LC, Ford KR, Hewett TE (2012) Incidence of contralateral and ipsilateral anterior cruciate ligament (ACL) injury after primary ACL reconstruction and return to sport. Clin J Sport Med 22:116–121PubMedPubMedCentralCrossRef
29.
go back to reference Paterno MV, Schmitt LC, Ford KR, Rauh MJ, Myer GD, Huang B, Hewett TE (2010) Biomechanical measures during landing and postural stability predict second anterior cruciate ligament injury after anterior cruciate ligament reconstruction and return to sport. Am J Sports Med 38:1968–1978PubMedPubMedCentralCrossRef Paterno MV, Schmitt LC, Ford KR, Rauh MJ, Myer GD, Huang B, Hewett TE (2010) Biomechanical measures during landing and postural stability predict second anterior cruciate ligament injury after anterior cruciate ligament reconstruction and return to sport. Am J Sports Med 38:1968–1978PubMedPubMedCentralCrossRef
30.
go back to reference Pinczewski LA, Lyman J, Salmon LJ, Russell VJ, Roe J, Linklater J (2007) A 10-year comparison of anterior cruciate ligament reconstructions with hamstring tendon and patellar tendon autograft a controlled, prospective trial. Am J Sports Med 35:564–574CrossRefPubMed Pinczewski LA, Lyman J, Salmon LJ, Russell VJ, Roe J, Linklater J (2007) A 10-year comparison of anterior cruciate ligament reconstructions with hamstring tendon and patellar tendon autograft a controlled, prospective trial. Am J Sports Med 35:564–574CrossRefPubMed
31.
go back to reference Prodromos CC, Han Y, Rogowski J, Joyce B, Shi K (2007) A meta-analysis of the incidence of anterior cruciate ligament tears as a function of gender, sport, and a knee injury–reduction regimen. Arthroscopy 23:1320–1325CrossRefPubMed Prodromos CC, Han Y, Rogowski J, Joyce B, Shi K (2007) A meta-analysis of the incidence of anterior cruciate ligament tears as a function of gender, sport, and a knee injury–reduction regimen. Arthroscopy 23:1320–1325CrossRefPubMed
32.
go back to reference Robinson RO, Herzog W, Nigg BM (1987) Use of force platform variables to quantify the effects of chiropractic manipulation on gait symmetry. J Manip Physiol Ther 10:172–176 Robinson RO, Herzog W, Nigg BM (1987) Use of force platform variables to quantify the effects of chiropractic manipulation on gait symmetry. J Manip Physiol Ther 10:172–176
33.
go back to reference Salmon L, Russell V, Musgrove T, Pinczewski L, Refshauge K (2005) Incidence and risk factors for graft rupture and contralateral rupture after anterior cruciate ligament reconstruction. Arthroscopy 21:948–957CrossRefPubMed Salmon L, Russell V, Musgrove T, Pinczewski L, Refshauge K (2005) Incidence and risk factors for graft rupture and contralateral rupture after anterior cruciate ligament reconstruction. Arthroscopy 21:948–957CrossRefPubMed
34.
go back to reference Santamaria LJ, Webster KE (2010) The effect of fatigue on lower-limb biomechanics during single-limb landings: a systematic review. J Orthop Sports Phys Ther 40:464–473CrossRefPubMed Santamaria LJ, Webster KE (2010) The effect of fatigue on lower-limb biomechanics during single-limb landings: a systematic review. J Orthop Sports Phys Ther 40:464–473CrossRefPubMed
35.
go back to reference Schmitt LC, Paterno MV, Ford KR, Myer GD, Hewett TE (2014) Strength asymmetry and landing mechanics at return to sport after ACL reconstruction. Med Sci Sports Exerc 47:1426–1434CrossRef Schmitt LC, Paterno MV, Ford KR, Myer GD, Hewett TE (2014) Strength asymmetry and landing mechanics at return to sport after ACL reconstruction. Med Sci Sports Exerc 47:1426–1434CrossRef
36.
go back to reference Shelbourne KD, Sullivan AN, Bohard K, Gray T, Urch SE (2009) Return to basketball and soccer after anterior cruciate ligament reconstruction in competitive school-aged athletes. Sports Health 1:236–241PubMedPubMedCentralCrossRef Shelbourne KD, Sullivan AN, Bohard K, Gray T, Urch SE (2009) Return to basketball and soccer after anterior cruciate ligament reconstruction in competitive school-aged athletes. Sports Health 1:236–241PubMedPubMedCentralCrossRef
37.
go back to reference Shultz SJ, Schmitz RJ, Cone JR, Henson RA, Montgomery MM, Pye ML, Tritsch AJ (2015) Changes in fatigue, multiplanar knee laxity, and landing biomechanics during intermittent exercise. J Athl Train 50:486–497PubMedPubMedCentralCrossRef Shultz SJ, Schmitz RJ, Cone JR, Henson RA, Montgomery MM, Pye ML, Tritsch AJ (2015) Changes in fatigue, multiplanar knee laxity, and landing biomechanics during intermittent exercise. J Athl Train 50:486–497PubMedPubMedCentralCrossRef
38.
go back to reference Sutton KM, Bullock JM (2013) Anterior cruciate ligament rupture: differences between males and females. J Am Acad Orthop Surg 21:41–50CrossRefPubMed Sutton KM, Bullock JM (2013) Anterior cruciate ligament rupture: differences between males and females. J Am Acad Orthop Surg 21:41–50CrossRefPubMed
39.
go back to reference Thomeé R, Kaplan Y, Kvist J, Myklebust G, Risberg MA, Theisen D, Tsepis E, Werner S, Wondrasch B, Witvrouw E (2011) Muscle strength and hop performance criteria prior to return to sports after ACL reconstruction. Knee Surg Sports Traumatol Arthrosc 19:1798–1805CrossRefPubMed Thomeé R, Kaplan Y, Kvist J, Myklebust G, Risberg MA, Theisen D, Tsepis E, Werner S, Wondrasch B, Witvrouw E (2011) Muscle strength and hop performance criteria prior to return to sports after ACL reconstruction. Knee Surg Sports Traumatol Arthrosc 19:1798–1805CrossRefPubMed
40.
go back to reference Webster KE, Austin DC, Feller JA, Clark RA, McClelland JA (2015) Symmetry of squatting and the effect of fatigue following anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc 23:3208–3213CrossRefPubMed Webster KE, Austin DC, Feller JA, Clark RA, McClelland JA (2015) Symmetry of squatting and the effect of fatigue following anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc 23:3208–3213CrossRefPubMed
41.
go back to reference Wright RW, Dunn WR, Amendola A, Andrish JT, Bergfeld J, Kaeding CC, Marx RG, McCarty EC, Parker RD, Wolcott M et al (2007) Risk of tearing the intact anterior cruciate ligament in the contralateral knee and rupturing the anterior cruciate ligament graft during the first 2 years after anterior cruciate ligament reconstruction a prospective MOON cohort study. Am J Sports Med 35:1131–1134CrossRefPubMed Wright RW, Dunn WR, Amendola A, Andrish JT, Bergfeld J, Kaeding CC, Marx RG, McCarty EC, Parker RD, Wolcott M et al (2007) Risk of tearing the intact anterior cruciate ligament in the contralateral knee and rupturing the anterior cruciate ligament graft during the first 2 years after anterior cruciate ligament reconstruction a prospective MOON cohort study. Am J Sports Med 35:1131–1134CrossRefPubMed
Metadata
Title
Anterior cruciate ligament reconstructed females who pass or fail a functional test battery do not exhibit differences in knee joint landing biomechanics asymmetry before and after exercise
Authors
Eunwook Chang
Samuel T. Johnson
Christine D. Pollard
Mark A. Hoffman
Marc F. Norcross
Publication date
01-06-2020
Publisher
Springer Berlin Heidelberg
Published in
Knee Surgery, Sports Traumatology, Arthroscopy / Issue 6/2020
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-019-05707-9

Other articles of this Issue 6/2020

Knee Surgery, Sports Traumatology, Arthroscopy 6/2020 Go to the issue