Isokinetic evaluation after two-stage bicruciate reconstruction

Abstract

Objective: To assess the functional balance of the knee after bicruciate reconstruction and its correlation with clinical score. Methods: 14 patients (11 men and three women), mean age 29.9±7.65 years, mean BMI 26.2±2.51 kg/m2 underwent surgical reconstruction of the Posterior Cruciate Ligament (PCL) and Anterior Cruciate Ligament (ACL) in two stages, with a mean interval of 3 months between procedures. With a mean follow-up period of 27.33 months, the isokinetic knee analysis was performed at 60°/s and 180°/s and the Lysholm and Tegner scores were applied. Results: The Lysholm score was 86.8±11.1 points and the Tegner score showed a deficit of 30% compared to pre-injury level. In isokinetic evaluation, the deficit of the operated quadriceps average torque was 17.05% at 60°/s and 12.16% at 180°/s, while the average flexor torque deficit was 3.43% at 60°/s and 5.82% at 180°/s. Although it was observed torque deficit between members, there were no statistical differences regarding the functional balance between hamstrings and quadriceps. Conclusion: Although the results of isokinetic evaluation has shown a functional balance of the knee (flexor-extensor), which may have contributed to the good subjective Lysholm score in the bicruciate two-stage reconstruction, two-stage reconstruction did not restore the pre-injury functional level. Level of Evidence IV, Case Series.

Bicruciate lesion biomechanics, Part 2—treatment using a simultaneous tensioning protocol: ACL fixation first is better than PCL fixation first to restore tibiofemoral orientation

“…They are the consequence of a knee dislocation and are frequently combined with additional injuries. There are many controversies regarding the ideal management of a bicruciate lesion, including the timing of surgery, one‐ or two‐stage reconstruction, the tensioning of the graft, the position of the knee during graft fixation, and the sequence of graft fixation [5, 6, 9, 13, 15, 17, 23]. These controversies are even more important in the setting of additional injuries as the ligaments can be fixed while the knee is subluxated.…”

Combined chronic anterior cruciate ligament and posterior cruciate ligament reconstruction: functional and clinical results

“…No statistically significant differences in any of the parameters measured during isometric testing between the two groups were found, but partially unexpected results that diverged from previous studies were noted. Takaes et al [13] performed isokinetic evaluation at 27 months of follow-up after two-stage bicruciate reconstruction with autografts in 14 patients. They reported a mean extensor peak torque of 167 and 122 Nm at an angular velocity of 60 and 180°/s, respectively, in the operated side and a mean flexor peak torque of 98 and 79 Nm at an angular velocity of 60 and 180°/s, respectively, in the operated side.…”

Posterior cruciate ligament reconstruction using PCL inlay technique with the patient supine in bicruciate ligament injury reconstruction

“…We originally, used an open technique [5,15,16]. Since 2009, drilling of the PCL femoral tunnel has been performed arthroscopically, and the tibial insertion of the PCL has been approached in an open fashion with the patient supine [17,18].…”