Knee Flexor Function 2 Years After Anterior Cruciate Ligament Reconstruction With Semitendinosus-Gracilis Autografts

All-Epiphyseal, All-Inside Anterior Cruciate Ligament Reconstruction Technique for Skeletally Immature Patients

“…This may improve the postoperative lower extremity knee flexor and internal rotator strength as compared with harvesting both the semitendinosus and gracilis tendons, which can be deficient even at 2 years postoperatively. [46][47][48][49][50][51][52][53][54][55][56][57][58] This technique is less anatomy distorting than the iliotibial band reconstruction technique, with lower postoperative morbidity. The sockets used with this technique are all epiphyseal and blind ended with a cortical bone bridge of at least 7 mm.…”

Comparison of knee flexion isokinetic deficits between seated and prone positions after ACL reconstruction with hamstrings graft: Implications for rehabilitation and return to sports decisions

“…9 The main finding of the present study is that knee flexor strength deficits are more pronounced when tested with the hip in neutral positions (as opposed to the conventional 90 • hip flexion position). Although the deficits decrease with time they remain more pronounced in the prone position 9 months after surgery.…”

“…A study at 2 year follow-up reported approximately 5% difference in knee flexion peak torque although it was not statistically significant. 9 On the other hand, a recent study that investigated medial hamstring myoelectric activation patterns found that at 6 years after ACLR they are still abnormal. 17 Longitudinal studies with longer follow-up are needed to determine the recovery of knee flexion strength in the longer term.…”

“…Knee flexion peak torque measurements in patients with ACLR have excellent reliability (intraclass correlation coefficients ≥0.90). 9 We measured both legs at each time as it has been previously demonstrated that isokinetic performance of the healthy leg changes during the course of the rehabilitation protocol after knee surgery. 12 A repeated measures MANOVA was performed with time (3, 4, 6, and 9 months) and position (seated, prone) as the independent variables and the two different isokinetic speeds (60 and 180 • /s) as the dependent variables.…”

“…To explain this paradox, recent research has suggested that knee flexion strength should be measured in deep knee flexion angles where the deficits are more obvious. 4,9,10 However, in most sports that involve cutting and landing the athlete rarely needs to perform activities from deep knee flexion angles. Instead, in most situations the athlete needs to function from a position where both the knee and the hip are close to neutral position.…”