Movement Strategies During the Penultimate and Final Steps of a Change of Direction Following Arthroscopic Partial Meniscectomy.

Persistent knee offloading is well-documented after arthroscopic partial meniscectomy (APM). Yet, it remains unclear if this extends to higher-demanding change-of-direction (CoD) tasks and how step-specific strategies influence joint loading. We aimed to compare joint power and relative contributions in the surgical limb, contralateral limb, and healthy individuals during a 90° CoD. A secondary aim examined the relationship between knee negative power at the penultimate and final foot contacts across limb sequences. Kinematic and kinetic data were collected from 24 post-APM and 20 healthy individuals using motion capture with force plates. Participants performed a running approach before executing a 90° CoD. Linear mixed-effects models compared limb differences and examined the relationship between steps. During penultimate contact, APM limb showed lower magnitudes of total (mean difference 2.80 W/kg, 95% CI 0.59, 5.00) and knee (2.60 W/kg, 0.75, 4.46) negative power than healthy limbs, with lower knee (-10.57%, -19.63, -1.52) and higher ankle (10.13%, 0.47, 19.79) contributions. During final contact, APM limb showed lower magnitudes of knee negative power (0.65 W/kg, 0.06, 1.24) than contralateral limbs. Compared with healthy, APM limb showed lower positive knee and ankle power, with lower knee (-7.23%, -14.19, -0.27) and greater hip (9.73%, 0.33, 19.13) contributions. Persistent knee deficits occurred post-APM, characterized by ankle-dominant braking and hip-dominant propulsion. Limb sequence influenced knee loading, with APM penultimate contact shifting braking to the contralateral limb at final contact. These findings suggest rehabilitation approaches may benefit from prioritizing knee function while preparing the ankle and hip to tolerate redistributed loads.