Evaluation of Quadriceps and Hamstring Muscles’ Elastrographic Properties after Anterior Cruciate Ligament Reconstruction

Abstract

Background. Tissue stiffness measurement by ultrasound elastography is commonly used for internal organs and tendons. In this study, rectus femoris, vastus medialis, vastus lateralis, biceps femoris, and semitendinosus muscles' stiffness of patients who underwent anterior cruciate ligament reconstruction surgery was followed up by ultrasound elastography. Methods. 19 male recreational athletes aged between 18-40 years who had undergone anterior cruciate ligament reconstruction surgery with semitendinosus grafting method were included in the study. All patients received a standardized home exercise program and a standardized supervised rehabilitation program. Thigh muscle stiffness measurements were performed at post-operative first-week, first-month, secondmonth, and third-month. Results. There was a significant difference between non-operated and operated knees at first measurement (p < 0.05). The second measurement was higher than the first, and the third measurement was higher than the second for both legs (p < 0.05). Rehabilitation process has increased muscle stiffness of both legs, and there was still a significant difference between non-operated and operated knees at third month (p < 0.05). Conclusions. Post-operatively decreased thigh muscle stiffness increases with physical rehabilitation. Therefore, ultrasound elastography can be used as an additional follow-up tool. Moreover, theoretically it might be a return to sports criteria if baseline values are available.