Differential Effects of 2 Rehabilitation Programs Following Anterior Cruciate Ligament Reconstruction

Abstract

Objective atrophy of Semitendinosus and Gracilis muscles related to surgical ACLR was found to persist in both rehabilitation groups. However, OCBR after ACLR lead to substantial gains on maximal knee flexor strength and ensured more symmetrical anterior-posterior laxity levels at the knee joint.

Quadriceps Muscle Size Following ACL Injury and Reconstruction: A Systematic Review

“…One study compared two groups of ACLR patients treated with two different, post‐surgical rehabilitation plans but identical surgeries. One group did exhibit pre‐surgical, between limb differences in quadriceps CSA, while the other group did not exhibit those same differnces . Due to the inclusion of an intervention after surgery, post‐surgical results from the study were not reported here; however, it is worth mentioning that no significant between limb differences in quadriceps CSA were found.…”

“…Three studies reported quadriceps CSA for both the ACL‐injured and contralateral limb prior to ACLR. In comparing the ACL‐injured limb to the contralateral limb, one study demonstrated a large, negative effect, one study demonstrated a moderate, negative effect, and one study demonstrated a small, negative effect. The effect size CIs of the two studies demonstrating a negative moderate or large, effect size did not cross zero indicating a meaningful difference, while the effect size CI of the study with a small, negative effect size did cross zero.…”

“…Using the modified Downs and Black checklist, assessment of the methodological quality of the 11 studies categorized five of the studies as low quality, five studies as moderate quality, and one study as high quality . Table (muscle volume) and Table (CSA) contain a detailed description of the methodological quality assessment of each included article.…”

“…Of the 11 included studies, only four studies found a meaningful difference between limbs as indicated by an effect size of 95% CI that did not cross zero. 12,24,46,47 A high 47 and moderate 12 methodological quality study reported a meaningful difference in quadriceps CSA before 12,47 and after ACLR, 12 and a moderate 46 and low methodological quality study 24 reported a meaningful difference between limbs based on muscle volume after ACLR. This evidence suggests that muscle atrophy may explain only a limited portion of the persistent quadriceps weakness that is common among individuals with ACL injury and ACLR.…”

“…Using the modified Downs and Black checklist, assessment of the methodological quality of the 11 studies categorized five of the studies as low quality, 24,[41][42][43] five studies as moderate quality, 12,25,28,[44][45][46] and one study as high quality. 47 Table 2 (muscle volume) and Table 3 (CSA) contain a detailed description of the methodological quality assessment of each included article. The assessing investigators disagreed on three articles, which was reconciled thorough discussion of the methods in each article.…”