Quadriceps strength to body weight ratio is a significant indicator for initiating jogging after anterior cruciate ligament reconstruction

Iwame, Toshiyuki; Matsuura, Tetsuya; Okahisa, Tetsuya; Katsuura‐Kamano, Sakurako; Wada, Keizo; Iwase, Jyoji; Sairyo, Koichi

doi:10.1016/j.knee.2020.12.010

Cited by 8 publications

(15 citation statements)

References 58 publications

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“…This study showed a highly significant association between an RTR and isokinetic parameters, which is consistent with previous studies [ 15 , 16 ]. The quadriceps LSI at 60°/s was found to be the most accurate parameter to predict a return to running, with a cutoff of 65% associated with good sensitivity and specificity.…”

Section: Discussionsupporting

confidence: 93%

“…A strength deficit often persists for more than 3 months post-surgery, so it is expected that the QS/BW increases between the 3rd and 4th months after surgery. These different delays may explain the lower rate of a return to running of 53% [16] compared to 63.2% in our study. It would have been interesting to know the proportion of complications (pain, effusion .…”

Section: Discussioncontrasting

confidence: 61%

“…There is sufficient proof in the literature to apply isokinetic criteria in the decision process [ 14 , 15 , 16 ]. Once the isokinetic test at 4 months was performed, we deemed it unethical to permit an RTR regardless of isokinetic parameters.…”

Section: Methodsmentioning

confidence: 99%

“…Furthermore, in this last study, the authors simultaneously included patients with Bone–Patellar Tendon–Bone (BPTB) and hamstring autograft procedures that led to different strength deficits: quadriceps strength was more impaired after BPTB and hamstring strength was more impaired after hamstring procedure [ 12 ]. There is also evidence for other isokinetic parameters of interest such as quadriceps strength reported to body weight (QS/BW) [ 16 ].…”

Section: Introductionmentioning

confidence: 99%

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Relevant Strength Parameters to Allow Return to Running after Primary Anterior Cruciate Ligament Reconstruction with Hamstring Tendon Autograft

Grondin

Crenn

Gernigon

et al. 2022

IJERPH

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After anterior cruciate ligament reconstruction (ACLR), a progressive process is followed from rehabilitation to the return to sport including a crucial step known as the return to running. Return to running (RTR) can be predicted by an isokinetic knee strength assessment at 4 months post-surgery. All patients who had primarily undergone ACLR with a hamstring autograft procedure between 2010 and 2020 were included in this study. Four months after surgery, patients were evaluated using an isokinetic knee strength test. Patients were monitored until the 6th month post-surgery to see if they had returned to running. Comparisons were carried out between the two groups—the RTR and the no-RTR. A multivariate logistic regression analysis was used to predict the RTR status from explicative parameters. Receiver Operating Characteristic (ROC) curves were established to identify cutoffs with their characteristics. A total of 413 patients were included and 63.2% returned to running at 4 months post-surgery. The mean Lysholm score, knee complication rate, and isokinetic parameters were statistically different between both groups. Using a multivariate logistic regression model and ROC curves, the best isokinetic parameter to assist with the decision to allow an RTR was the quadriceps limb symmetry index at 60°/s with a cutoff of 65%. The hamstring LSI at 180°/s could be added (cutoff of 80%) to slightly increase the prediction of an RTR. Quadriceps strength normalized to body weight at 60°/s is a useful parameter (cutoff: 1.60 Nm/kg) but measurements on both sides are necessary. Isokinetic parameters are objective parameters to allow a return to running at 4 months after ACLR with a hamstring procedure.

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Section: Discussionsupporting

confidence: 93%

Section: Discussioncontrasting

confidence: 61%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Relevant Strength Parameters to Allow Return to Running after Primary Anterior Cruciate Ligament Reconstruction with Hamstring Tendon Autograft

Grondin

Crenn

Gernigon

et al. 2022

IJERPH

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“…A return to running progression begins once the athlete attains sufficient quadriceps strength, masters preparatory running drills, and meets performance targets with clinical testing (Table 2). Recently, Iwame et al 75 reported that those individuals who met a cutoff value for quad strength divided by body weight of 1.45 Nm/kg had success with return to jogging, highlighting the importance of strength for normal running gait. A minimum period of 4 weeks with a jogging buildup program should be completed before the initiation of straight-line sprint progressions.…”

Section: Return To Run and Sprintmentioning

confidence: 99%

Postoperative Rehabilitation and Return to Sport Following Multiligament Knee Reconstruction

Monson

Schoenecker

Schwery³

et al. 2022

Arthroscopy, Sports Medicine, and Rehabilitation

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Multiligament knee injuries (MLKIs) are debilitating injuries that increasingly occur in young athletes. Return to sport (RTS) has historically been considered unlikely due to the severity of these injuries. Reporting in the literature regarding objective outcomes following MLKI, including RTS, is lacking, as are clear protocols for both rehabilitation progressions and RTS testing. RTS following MLKI is a complex process that requires an extended recovery duration compared to other surgery types. Progressions through postoperative rehabilitation and RTS should be thoughtful, gradual, and criterion based. After effective anatomic reconstruction to restore joint stability, objective measures of recovery including range of motion, strength, movement quality, power, and overall conditioning guide decision-making throughout the recovery process. It is important to frame the recovery process of the athlete in the context of the severity of their injury, as it is typically slower and less linear. Improved reporting on objective outcomes will enhance our understanding of recovery expectations within this population by highlighting persistent deficits that may interfere with a full recovery, including RTS.M ultiligament knee injuries (MLKIs) are defined as a tear of 2 or more of the major knee ligaments, which include the anterior cruciate ligament (ACL), posterior cruciate ligament (PCL), medial collateral ligament (MCL), and lateral collateral ligament or fibular collateral ligament (FCL). 1,2 These devastating injuries are relatively uncommon, with more recent reports of 0.072 events per 100-patient years within the general population. 1,3,4 MLKIs are often associated with knee dislocation, defined as a rupture of both cruciates with or without additional grade III injury to one of the collaterals. 5 Disruption of the popliteal artery and/or common peroneal nerve (CPN) constitutes a medical emergency that can have devastating consequences if unrecognized. 6 MLKIs are seen more commonly in younger patients, with a mean age of 37 AE 15 years. 7,8 The incidence of knee dislocation has been inversely correlated with age. 7,8 MLKIs are often associated with high-energy trauma such as a motor vehicle accidents or fall from a height; however, nearly 50%, occur through a low-velocity mechanism, most commonly sport. 9,10 Rates of MLKI caused by skiing sports and ball sports are as high as 29.4% and 6.9%, respectively. In the same cohort, motor vehicle accidents only accounted for 19.2% of all injuries. 7 Given the severity of MLKI and the complexity of multiligament knee reconstruction (MLKR), return to sport (RTS) has historically been considered highly unlikely. RTS data have been inconsistent and incomplete, but existing evidence cites a RTS rate of 53%, 11 with competitive athletes having a lower RTS rate of 22%. 11 While surgical proficiency with MLKR has improved, RTS may be hindered by concerns regarding long-term joint health. MLKI patients show high rates of concomitant injury to articular cartilage (28.3%-48%) and men...

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Anterior Cruciate Ligament Injury Recovery in Adolescent Athletes

Garrison,

Hannon

2024

Sports Injuries

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Quadriceps strength to body weight ratio is a significant indicator for initiating jogging after anterior cruciate ligament reconstruction

Cited by 8 publications

References 58 publications

Relevant Strength Parameters to Allow Return to Running after Primary Anterior Cruciate Ligament Reconstruction with Hamstring Tendon Autograft

Relevant Strength Parameters to Allow Return to Running after Primary Anterior Cruciate Ligament Reconstruction with Hamstring Tendon Autograft

Postoperative Rehabilitation and Return to Sport Following Multiligament Knee Reconstruction

Anterior Cruciate Ligament Injury Recovery in Adolescent Athletes

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