Isokinetic and Anterior Cruciate Ligament Reconstruction with Hamstrings or Patella Tendon Graft: Analysis of Literature

Abstract

We report isokinetic results of anterior cruciate ligament reconstruction with patellar tendon or hamstring graft from the literature analysis. The literature was defined from two search "textwords": Isokinetic and Anterior cruciate ligament reconstruction, and from three databases: Medline, Pascal, and Herasmus. Two independent physicians (Physical Medicine and Rehabilitation) carried out an analysis according to the French National Accreditation and Health Evaluation Agency recommendations. Fifty-three studies were selected: 29 reported isokinetic results after anterior cruciate ligament reconstruction with patellar tendon graft, 15 reported isokinetic results after anterior cruciate ligament reconstruction with hamstring graft, and 9 studies compared the two surgical procedures. After discussing different bias and in reference to prospective randomised and comparative studies, the anterior cruciate ligament reconstruction with patellar tendon graft involves a knee extensors deficit during several months. The hamstring surgical procedure involves a less important knee extensor deficit (from 6 to 19 % against 8 to 21 %). Knee sprain and intra-articular surgery involve a long-lasting knee extensors deficit. Anterior cruciate ligament reconstruction with hamstrings graft involves a knee flexors deficit over several months. The patellar tendon surgical procedure involves a less important knee flexors deficit (from 1 to 15 % against 5 to 17 %). In reference to isokinetic parameters, no difference between the two surgical procedures (patellar tendon graft or hamstring graft) is shown after more than twenty-four post-surgical months.

Return to play following ACL reconstruction: a systematic review about strength deficits

“…Two previously systematic reviews focus on flexor and extensor strength only and the results were contradictory. Dauty et al [19] stated that there was no difference between patellar tendon graft or hamstring graft with regard to isokinetic strength of knee flexors and extensor after more than 24 post-surgical months. Xergia et al [80] found that patients with an autologous patellar tendon graft showed a greater deficit in extensor muscle strength and lower deficit in flexor muscle strength compared with patients with hamstring tendon graft.…”

Anterior cruciate ligament reconstruction best practice: A review of graft choice

“…A systematic review by Dauty et al [48] reporting on isokinetic results following ACL reconstruction included 53 studies; 29 reported isokinetic results after ACL reconstruction with patellar tendon graft, 15 reported isokinetic results after ACL reconstruction with hamstring graft, and 9 studies compared the two surgical procedures. Comparing the two graft choices, they found that BOB vs hamstring resulted in a larger knee extensor deficit but less knee flexion weakness for up to two years.…”

Prediction of hamstring injury in professional soccer players by isokinetic measurements

“…The young players of the training centre and the professional players who presented significant injury of the lower limbs in the year which preceded isokinetic strength tests were excluded. The knee surgeries, quadriceps injuries, and hamstring injuries having obliged to stop training of more than 7 days, were excluded because of the durable loss of force that these various pathologies can engender 10,17 .…”