Knee isokinetic performance following anterior cruciate ligament reconstruction: patellar tendon versus hamstrings graft

Machado, Felipe Alves; Debieux, Pedro; Kaleka, Camila Cohen; Astur, Diego Costa; Peccin, Maria Stella; Cohen, Moisés

doi:10.1080/00913847.2018.1418592

Cited by 21 publications

(19 citation statements)

References 33 publications

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“…Only 40% of the PT patients passed the LSI > 90% quadriceps strength at 60°/s at 9 months compared to 63.9% of the HT patients. This is in line with previous research, showing a greater quadriceps deficit in PT patients compared with HT patients at 6 months after ACLR [ 28 ].…”

Section: Discussionsupporting

confidence: 93%

Low rates of patients meeting return to sport criteria 9 months after anterior cruciate ligament reconstruction: a prospective longitudinal study

Welling¹,

Benjaminse

Seil

et al. 2018

Knee Surg Sports Traumatol Arthrosc

127

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PurposeThe purpose of the current prospective study was to assess the changes over time in patients tested at 6 months and 9 months after anterior cruciate ligament reconstruction (ACLR) with a return to sport (RTS) test battery. It was hypothesized that more patients passed RTS criteria at 9 months compared to 6 months.MethodsSixty-two ACLR patients performed a test battery at an average of 6.5 ± 0.7 and 9.5 ± 0.9 months after ACLR. All patients underwent a standardized rehabilitation protocol. The test battery consisted of the following tests: a jump-landing task assessed with the Landing Error Scoring System (LESS), three single-leg hop tasks (single-leg hop test, triple-leg hop test, side hop test), isokinetic quadriceps and hamstring strength at 60, 180 and 300°/s and two questionnaires (IKDC and ACL–RSI). Cut off criteria were set as Limb Symmetry Index (LSI) > 90% (for isokinetic strength and for single-leg hop tasks), LESS < 5, IKDC score within 15th percentage of healthy subjects and ACL–RSI > 56 respectively.ResultsAt 6 months, two patients (3.2%) passed all criteria. At 9 months, seven patients (11.3%) passed all criteria. Patients improved in all RTS criteria over time except for the IKDC score. Twenty-nine patients (46.8%) did not pass the strength criterion at 60°/s at 9 months after ACLR.ConclusionsThe percentages of patients passing all RTS criteria were low at both 6 and 9 months after ACLR. Quadriceps strength revealed persistent deficits and the lack of improvement in the IKDC score questionnaires shows insufficient self-reported knee function for RTS.Level of evidenceIII.

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Section: Discussionsupporting

confidence: 93%

Low rates of patients meeting return to sport criteria 9 months after anterior cruciate ligament reconstruction: a prospective longitudinal study

Welling¹,

Benjaminse

Seil

et al. 2018

Knee Surg Sports Traumatol Arthrosc

127

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“…On the other hand, subjects in this study were only patients who underwent reconstruction with a hamstring graft. Postoperative symptoms and recovery patterns of knee extension/ exion strength differ depending on the type of graft used for reconstruction 19,20 . Therefore, the relationship between anterior OLH distance and knee extension/ exion strength may have differed between this and the previous study.…”

Section: Discussionmentioning

confidence: 99%

“…Values and relationships of OLH distance and knee strength may differ between dominant and non-dominant legs, but these were not analyzed separately 37 . Patterns of recovery for postoperative knee strength differ depending on whether the graft used in reconstruction is a hamstring or patellar tendon 19,20 . As this study targeted only patients after reconstruction with hamstring grafts, generalization of the ndings to patients after reconstruction with patellar tendon graft remains limited.…”

Section: Discussionmentioning

confidence: 99%

“…In their study, 19 of 29 patients (66%) underwent reconstruction with patellar tendon. Patterns of restoration of knee extensor and exor strength differ between patients after reconstruction using patellar tendon and after reconstruction using hamstring graft 19,20 . Whether the results of the study by Sueyoshi et al, which suggest that knee exor strength is more related to OLH distance than knee extensor strength, are directly applicable to patients after reconstruction using hamstring graft is thus unclear.…”

Section: Introductionmentioning

confidence: 99%

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Knee Extensor and Flexor Strength are Related to One-Leg Hop Distances in Three Directions in Patients Six Months After Anterior Cruciate Ligament Reconstruction

Aizawa¹,

Hirohata²,

Ohji³

et al. 2020

Preprint

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Background: When planning rehabilitation and conditioning for performance enhancement and a return to sports after anterior cruciate ligament reconstruction, identifying the elements of physical function associated with one-leg hop is important. The purpose of this study was to clarify the relationship between one-leg hop distances in 3 directions and knee extensor and flexor strengths at 6 months after reconstruction.Methods: Participants were 47 patients taking part in training sessions for sports involving cutting, pivoting, and jump-landing 6 months after reconstruction using a hamstring tendon. Demographics, activity scale score, days before and after reconstruction, and meniscus surgery procedure were analyzed. One-leg hop distances in 3 directions (anterior, lateral, and medial) and isokinetic strengths of knee extension and flexion were measured. Simple regression analyses using Spearman's rank correlation coefficient were performed to assess relationships between one-leg hop distances and knee strengths.Results: In the involved limb, correlations between one-leg hop distance in 3 directions and knee strengths were significant and effect sizes ranged from medium to large. Correlation coefficients between all one-leg hop parameters and knee extension/flexion strengths at an angular velocity of 180°/s were greater than those of 60°/s.Conclusions: Knee strength showed moderate to high associations with lateral and medial one-leg hop distances in addition to anterior one-leg hop distance. The results of this study will be useful in planning and teaching conditioning to improve multi-directional one-legged hop skills and improve knee strength for a full-scale return to sports after reconstruction.

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“…The interactions between the structures of ligaments, tendons, meniscus, and capsule and the dynamic muscle system produce functional stability of the knee joint. 4 The anterior cruciate ligament (ACL) has the mechanical function of maintaining the stability of the knee joint and contains mechanoreceptors, which directly affect neuromuscular control of the knee joint. 5 It also acts as a static stabilizer, preventing hyperextension of the knee joint, anterior tibial translation, and rotatory movements.…”

Section: Introductionmentioning

confidence: 99%

Comparing Changes in Knee Muscle Strength after Reconstruction of the Anterior and Posterior Cruciate Ligaments

Hyun

Kim

2019

J Kor Phys Ther

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Purpose:The purpose of this study was to identify changes in knee muscle strength after reconstruction of the anterior cruciate ligament (ACL) and the posterior cruciate ligament (PCL). Methods: Thirteen subjects (males) with anterior ligament injury and ten subjects (males) with posterior ligament injury voluntarily participated in this study. Both groups were evaluated at the pre-and post-reconstruction stages using an isokinetic dynamometer. Peak torque, total work, and the hamstrings to quadriceps (H/Q) peak torque ratio were calculated at angular velocities of 60°/sec and 180°/ sec. Statistical analysis was conducted on SPSS 18.0 for Windows using t-tests to compare mean differences. Results: At an angular velocity of 60°/sec, both the ACL and PCL groups showed a significant increase in muscle strength in the flexors and extensors. Muscle strength in the extensors was significantly increased in the PCL group compared to the ACL group. At an angular velocity of 180°/sec, the ACL group showed a significant increase in muscle endurance in the flexors and extensors, and the PCL group showed a significant increase in muscle endurance in the flexors. At angular velocities of 60°/sec and 180°/sec, the H/Q peak torque ratio increased in the ACL group but decreased in the PCL group. Consequently, the H/Q peak torque ratio was significantly different for the two groups. Conclusion: The results suggest that the patients with ACL injury should focus on strengthening the knee extensors and that the patients with PCL injury need to strengthen the knee flexors. Keywords: Anterior cruciate ligament, Posterior cruciate ligament, Muscle strength stability against varus, valgus, and external rotation. 9 Hughston et al. 10 have emphasized the importance of the PCL as a critical stabilizer of the knee joint. Anterior cruciate ligament injuries are divided into contact injuries and noncontact injuries. About 70-80% of ACL injuries are noncontact injuries, whereas only 20-30% are contact injuries. 11 Noncontact injuries are caused by single-foot landing, direct deceleration, and pivoting, twisting, and cutting movements without direct physical contact. 12 Noncontact injuries, on the other hand, are often accompanied by injuries of the medial meniscus and medial collateral ligament which are caused by strong varus external forces. 13The PCL has two major injury mechanisms. The first occurs during posterior translation of the proximal tibial bone when the knee joint is bent. Most injuries are caused by serious impact on the antero-proximal tibia (dashboard injury) due to traffic accidents and by falling when the knee joint is bent during sports activities. 14,15 The second mechanism occurs when excessive force is exerted on the PCL during forced over-flexion or extension of the knee joint. 16,17 Cruciate ligament injuries cause various problems in the knee joint and its periphery. Anterior cruciate ligament injury may lead to knee joint pain, instability, and secondary osteoarthritis of the knee. It can also cause serious impairment...

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Knee isokinetic performance following anterior cruciate ligament reconstruction: patellar tendon versus hamstrings graft

Cited by 21 publications

References 33 publications

Low rates of patients meeting return to sport criteria 9 months after anterior cruciate ligament reconstruction: a prospective longitudinal study

Low rates of patients meeting return to sport criteria 9 months after anterior cruciate ligament reconstruction: a prospective longitudinal study

Knee Extensor and Flexor Strength are Related to One-Leg Hop Distances in Three Directions in Patients Six Months After Anterior Cruciate Ligament Reconstruction

Comparing Changes in Knee Muscle Strength after Reconstruction of the Anterior and Posterior Cruciate Ligaments

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