Muscle performance after anterior cruciate ligament reconstruction

Kobayashi, Atsushi; Handa, Hiroshi; Terauchi, Masanori; Kobayashi, Fumiko; Kimura, Masashi; Takagishi, Kenji

doi:10.1007/s00264-003-0502-5

Cited by 101 publications

(89 citation statements)

References 19 publications

(21 reference statements)

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“…Extensive research demonstrates quadriceps deficits can be present at six months and even up to and exceeding one year. [1][2][3][4][5] Quadriceps strength has recently been shown to help predict reinjury rate. Grindem et al 20 found that individuals following ACL-R with a quadriceps strength deficit of greater than 10% are significantly more likely to reinjure their ipsilateral ACL.…”

Section: Discussionmentioning

confidence: 99%

“…The tendon and surrounding structures including the infrapatellar fat pad play a crucial role in the ability to generate strength. 3 Although patients were instructed to stop all testing secondary to an increase in pain, none chose to do so. All participants were able to complete testing without complaints of pain.…”

Section: Limitationsmentioning

confidence: 99%

“…Greater quadriceps strength pre-operatively has been correlated to increased quadriceps strength post-operatively. However, it is well documented that quadriceps strength deficits may remain for two years and beyond, following ACL-R. [1][2][3][4][5] Multiple authors have shown that those individuals with greater quadriceps strength pre-operatively have significantly greater quadriceps strength at RTS, and those with lower quadriceps strength pre-operatively have lower functional scores on single and triple hop tests (time and distance) at time of RTS and may take longer to RTS after ACL-R. 1, 2,6 Quadriceps strength is important as it relates to outcomes and performance at time of RTS. 2,7 Recently, researchers have found that decreased quadriceps strength, and larger asymmetries between limbs, lead to shorter distances on hop tests.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

The Relationship Between Pre-Operative and Twelve-Week Post-Operative Y-Balance and Quadriceps Strength in Athletes With an Anterior Cruciate Ligament Tear

Hallagin

Garrison

Creed

et al. 2017

Intl J Sports Phys Ther

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Background: Pre-operative quadriceps strength may have a positive influence on post-operative function and outcomes at time of return to sport. Little consideration has been given to quadriceps strength during the early post-operative timeframes. Twelveweek post-operative anterior cruciate ligament reconstruction (ACL-R) is considered a critical time point for progression in the rehabilitation process. There is currently limited research looking at the relationship between clinical measurements pre-operatively and at 12-weeks following ACL-R. Purpose/Hypothesis:The primary purpose of this study was to examine the differences between Y-Balance Test Lower Quarter (YBT-LQ) and isokinetic quadriceps strength tested pre-operatively and post-operatively following ACL-R (12-weeks). Study Design: Within subject, repeated measuresMethods: Thirty-nine participants (15.6±1.5 y/o) were diagnosed with an ACL tear and were undergoing rehabilitation to return to a sport requiring cutting and pivoting were included. YBT-LQ and isokinetic quadriceps strength were assessed pre-operatively and at 12-weeks after ACL-R. YBT-LQ composite scores were calculated bilaterally and isokinetic quadriceps strength was tested using the Biodex Multi-Joint Testing and Rehabilitation System. Paired T-tests were used to determine mean group differences between YBT-LQ and isokinetic quadriceps strength scores pre-operatively and at 12-weeks post-operative. A Pearson Correlation was performed to determine relationships between variables at both time points.Results: There was a significant improvement in YBT-LQ composite scores from pre-operative to 12-weeks post-operative on both the involved p<0.001) limbs. Quadriceps strength decreased significantly from pre-operative to 12-weeks on the involved limb (Pre-operative: 82.3 ftlbs ± 38.6; 12-weeks: 67.9 ftlbs±27.4, p<0.01), but no differences were found on the uninvolved limb (Pre-operative: 117.3ftlbs ± 42.0; 12-weeks: 121.7ftlbs ± 41.5, p = 0.226). Conclusions:Involved limb quadriceps strength decreases from time of pre-operative to 12-weeks following ACL-R. Level of Evidence: 3

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Section: Discussionmentioning

confidence: 99%

Section: Limitationsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The Relationship Between Pre-Operative and Twelve-Week Post-Operative Y-Balance and Quadriceps Strength in Athletes With an Anterior Cruciate Ligament Tear

Hallagin

Garrison

Creed

et al. 2017

Intl J Sports Phys Ther

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“…The magnitude of atrophy and strength loss often exceeds 20% and 30%, respectively, during the first 3 months following surgery. 7,15,22,25,26,[29][30][31][32]34 Resistance exercises during postoperative rehabilitation predictably mitigate these deficits; however, a 10% decrease in muscle size and a 10% to 20% decrease in strength may persist years after surger y. 1,5,[7][8][9]12,19,22,25,28 Regaining quadriceps size and strength is clearly difficult following ACL-R and continues to be a rehabilitation challenge requiring novel interventions.…”

mentioning

confidence: 99%

Early Application of Negative Work via Eccentric Ergometry Following Anterior Cruciate Ligament Reconstruction: A Case Report

Gerber

Marcus

Dibble

et al. 2006

J Orthop Sports Phys Ther

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Study Design: Case report.Objectives: To present a progressively increasing negative-work exercise program via eccentric ergometry early after anterior cruciate ligament reconstruction (ACL-R) and to suggest the potential of negative work to amplify the return of quadriceps size and strength. Case Description: The patient was a 26-year-old highly active recreational athlete who sustained an ACL tear while skiing in January 2004 and then again while skiing in February 2005. This individual underwent an arthroscopically assisted ACL-R with a double-loop semitendinosusgracilis autograft initially, then a patellar tendon autograft following his ACL graft rupture. Beginning within 3 weeks after surgery, a progressive negative-work exercise program was initiated using an eccentric ergometer. The patient completed 31 training sessions of 5 to 30 minutes in duration over a 12-week period following the ACL-R and 33 training sessions of the same frequency and duration following the ACL revision. Outcomes: Following ACL-R, quadriceps volume increased 28% (involved lower extremity) and 14% (uninvolved lower extremity) during the 12-week training program. Following revision, quadriceps volume returned to similar levels at the same postoperative period as those achieved after the initial surgery (2% less on the involved side and 2% greater on the uninvolved side). Quadriceps strength, 15 weeks after ACL-R, exceeded preoperative measures by an average of 20% (involved) and 14% (uninvolved). Quadriceps strength after ACL revision exceeded all previous measures. Discussion: This case report suggests that if gradually and progressively applied, negative work via eccentric ergometry can be both safe and efficacious early after ACL-R. Eccentric exercise may mitigate the prevalent muscle size and strength deficits commonly observed after ACL-R. The results of this case suggest a need for continued research with early negative work interventions following ACL-R.

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“…The goal of ACL reconstruction is clearly to reinstate the previous complete knee stability with proper muscle function and full knee mobility [17]. To achieve that, surgeons reconstruct the ruptured ACL, mostly applying one of two types of autografts: bone-patellartendon and bone and hamstring-tendon graft [7,8,22], although some other techniques are also in use [21].…”

Section: Introductionmentioning

confidence: 99%

Electromyographic analysis of the knee using fixed-activation threshold after anterior cruciate ligament reconstruction

Kasović

Mejovšek

Matković

et al. 2010

International Orthopaedics (SICOT)

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The aim of this study was to establish whether there are any electromyographic (EMG) differences after two different surgical techniques in two years follow-up after anterior cruciate ligament (ACL) reconstruction. Study participants were divided into three groups. The control group included healthy athletes (C), the first study group (E1) consisted of injured athletes who were treated by ACL reconstruction using patellar tendon graft and the second study group (E2) comprised injured athletes treated by gracilis and semitendinosus tendon graft. The threshold of muscle activity was defined as 30% of maximum amplitude of EMG signal medial envelope of individual muscles in the control group. Two years after reconstruction, the E2 group achieved the maximum amplitude of biceps femoris muscle signal in the takeoff phase statistically significantly later than the E1 group (0.0166, p=0.05 and 0.015152, p=0.05/3= 0.016), whereas the rectus femoris muscle in the flight phase in the E2 group improved statistically significantly earlier than in the C group (0.0393, p=0.05 and 0.025974, p=0.05/3= 0.016). The results of this study show particularly statistically significant differences between observed surgery techniques, which led to the change of the neuromuscular pathway during simple and controlled knee movements even two years after ACL reconstructions in athletes who returned to active training. These disturbances of muscle work coordinations in the knee joint could be tied to the function and location from which the graft was taken rather than the quality of the transplant itself. This may result in an increased risk of repeated knee injury, including potential permanent health consequences in athletes. Based on the results of this research, we were unable to establish which of the presented ACL reconstruction techniques is more appropriate. This study may be useful for athletes and their coaches, who could plan, programme and adequately adjust their training process, thereby improving knee function in the best possible way, which in turn would maintain and extend athletes' respective sports careers.

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Muscle performance after anterior cruciate ligament reconstruction

Cited by 101 publications

References 19 publications

The Relationship Between Pre-Operative and Twelve-Week Post-Operative Y-Balance and Quadriceps Strength in Athletes With an Anterior Cruciate Ligament Tear

The Relationship Between Pre-Operative and Twelve-Week Post-Operative Y-Balance and Quadriceps Strength in Athletes With an Anterior Cruciate Ligament Tear

Early Application of Negative Work via Eccentric Ergometry Following Anterior Cruciate Ligament Reconstruction: A Case Report

Electromyographic analysis of the knee using fixed-activation threshold after anterior cruciate ligament reconstruction

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