Do peak torque angles of muscles change following anterior cruciate ligament reconstruction using hamstring or patellar tendon graft?

Abstract

ÖZAmaç: Bu çalışmada, otojen hamstring veya patellar tendon grefti kullanılan ön çapraz bağ (ÖÇB) rekonstrüksiyonun zirve tork açısı üzerindeki etkileri karşılaştırıldı. Hastalar ve yöntemler: Çalışmaya otojen hamstring veya patellar tendon grefti ile ÖÇB rekonstrüksiyonu uygulanan 132 hasta (103 erkek, 29 kadın; ort. yaş 29±9 yıl) dahil edildi. Kuadriseps ve hamstring kaslarındaki zirve tork açıları izokinetik dinamometre kullanılarak kaydedildi. Bulgular: Hamstring tendon grubunda zirve diz fleksiyonu tork açısı hareket açıklığında ameliyat edilen tarafta ameliyat edilmeyen taraftan 180°/saniyede anlamlı şekilde daha erken oluştu. Patellar tendon grubunda zirve diz fleksiyonu tork açısı hareket açıklığında ameliyat edilen tarafta ameliyat edilmeyen taraftan 180°/saniyede anlamlı şekilde daha erken oluştu. Her iki grupta ameliyat edilen ve edilmeyen dizler arasında 60°/saniyede fleksiyon ve ekstansiyon zirve tork açılarında istatistiksel olarak anlamlı farklılıklar yoktu. Sonuç: Göreceli olarak yüksek açısal hızlarda zirve tork açısı ÖÇB rekonstrüksiyonu sonrasında hamstring veya patellar tendon grefti olan hastalarda etkilenmektedir. Greft donör sahası bu parametreyi doğrudan etkilemektedir. Bu bulgu yeniden yaralanmanın önlenmesi açısından klinisyenler için önemli olabilir.Anahtar sözcükler: Atletik performans; hamstring tendon grefti; kas gücü dinamometresi; patellar tendon grefti; tork. ABSTRACT Objectives:This study aims to compare the effects of anterior cruciate ligament (ACL) reconstruction using autogenous hamstring or patellar tendon graft on the peak torque angle. Patients and methods: The study included 132 patients (103 males, 29 females; mean age 29±9 year) who were performed ACL reconstruction with autogenous hamstring or patellar tendon graft. The peak torque angles in the quadriceps and hamstring muscles were recorded using an isokinetic dynamometer. Results: Angle of peak knee flexion torque occurred significantly earlier within the range of motion on the operated side than nonoperated side at 180°/second in the hamstring tendon group. Angle of peak knee extension torque occurred significantly earlier within the range of motion on the operated side than nonoperated side at 180°/second in the patellar tendon group. There were no statistically significant differences in the flexion and extension peak torque angles between the operated and nonoperated knees at 60°/second in both groups. Conclusion: The angle of peak torque at relatively high angular velocities is affected after ACL reconstruction in patients with hamstring or patellar tendon grafts. The graft donor site directly influences this parameter. This finding may be important for clinicians in terms of preventing re-injury.

Peak torque angle of anterior cruciate ligament-reconstructed knee flexor muscles in patients with semitendinosus and gracilis autograft is shifted towards extension regardless of the postoperative duration of supervised physiotherapy

“…PT is the most commonly utilized strength variable in isokinetic testing; however, there have been authors who analysed changes in the PT angle in patients after ACLR [12]. According to Yosmaoğlu et al (2017), the ACL-reconstructed knee flexor muscle PT angle at 180°/s shifts towards extension if the graft is harvested from hamstring tendons [12]. The present study confirmed this observation.…”

“…The exercise under isokinetic conditions involves a dynamic pre-set fixed velocity, with resistance varying exactly in response to the force applied by the individual, throughout a specified ROM. PT is the most commonly utilized strength variable in isokinetic testing; however, there have been authors who analysed changes in the PT angle in patients after ACLR [12]. According to Yosmaoğlu et al (2017), the ACL-reconstructed knee flexor muscle PT angle at 180°/s shifts towards extension if the graft is harvested from hamstring tendons [12].…”

“…The minimum size of the tested sample was determined based on other studies using the angle of PT of knee joint flexor muscles. According to Yosmaoğlu et al (2017) [12], who performed a power analysis based on previous studies by Brockett et al (2004) [23] and Proske et al (2004) [24], three groups of 28 participants each would be the minimum required to demonstrate a 95% difference in the angle of PT.…”

“…In regards to isokinetic testing, the PT, defined as the single highest torque output produced by a muscle contraction as the limb moves through the range of motion [11], has tended to be the most commonly utilized strength variable in studies evaluating knee flexor strength in patients after ACLR. Nevertheless, the assessment of this parameter may be insufficient, as there are also authors who have observed that the ACL-reconstructed knee flexor PT angle, also called the angle of occurrence referring to the angle at which PT occurs in the ROM, is shifted towards extension in patients after ACLR using a hamstring graft [12]. According to the literature, the knee flexor muscles weakness observed in deeper angles of knee flexion angles may influence performance in sports, in which knee flexion strength is required at deep flexion angles, such as in gymnastics, judo or wrestling [3, 5, 13].…”

Angle specific analysis of hamstrings and quadriceps isokinetic torque identify residual deficits in soccer players following ACL reconstruction: a longitudinal investigation

“…(Welling et al, 2018) This is likely due to altered neural and morphological characteristics. (Lepley et al, 2019) However, the angle of peak torque was not different in either limb at any timepoint consistent with previous research (Ikeda et al, 2002;Yosmaoglu et al, 2017) or within-limbs across the three assessments. Conversely, SPM showed lower torques on the involved limb over the entire ROM [28-81°] during the first test, but the differences were reduced to 32-81° and 51-80° during the second and third assessments, respectively.…”