Strengthening exercises for old cruciate ligament tears

Thirty-nine patients with ruptures of the anterior cruciate ligament (ACL) were treated conservatively and were subsequently examined at an average of 5.7 years after injury, the uninjured leg acting as a control. The Tegner activity score was significantly lower than the desired activity level. No patients were free of symptoms and only two could take part in sport which involved pivoting. The isokinetic knee extensor and flexor torques, as well as the one-leg-hop and instrumented knee joint laxity tests, were significantly impaired at follow-up. Functional impairment was not related to tests of knee joint laxity. Few patients were pleased with their subjective knee function after an ACL rupture despite thorough initial rehabilitation.

Section: Discussionmentioning

confidence: 48%

Knee function after anterior cruciate ligament ruptures treated conservatively

Engström¹,

Gornitzka

Johansson³

et al. 1993

“…As Murray et al [6] and Tegner et al [10,11] have reported, quadriceps strength in patients with an ACL injury is significantly reduced. Baugher et al [1] also reported that quadriceps in patients with an ACL injury showed evidence of atrophy.…”

Section: Discussionmentioning

confidence: 57%

Quadriceps torque curve pattern in patients with anterior cruciate ligament injury

Ikeda

Kurosawa

Kim

2002

We measured torque curve pattern and quadriceps muscle strength with the knee slightly flexed in 48 patients with an anterior cruciate ligament injury, and analyzed the factors associated with reduced quadriceps strength. Strength was measured under isokinetic contraction, and concentric and eccentric contractions were studied. Strength was significantly lower in the injured knee, which also showed abnormal patterns of torque curve. In addition to the rapid downward slope pattern usually associated with concentric contraction, there was a concave pattern during eccentric contraction.Résumé Nous avons mesuré le moment de rotation et la force du quadriceps à la flexion légère du genou chez 48 malades ayant une lésion du ligament croisé antérieur (ACL), et a analysé les facteurs associé s à l'affaiblissement de la force quadricipitale. La force des quadriceps a été mesurée sous contraction isocinétique, et les contractions concentriques et excentriques ont été étudiées. La force des quadriceps était considérablement inférieure sur le genou blessé comparé au genou opposé, indemne. Le genou blessé a aussi montré des modèles de moment de rotation distinct des modèles normaux. En plus de la rapide décroissance habituellement rapportée pendant la contraction concentrique, un modèle concave a été observé pendant la contraction excentrique.

“…Weak quadriceps are often related to chronic ACL insufficiency [5], as well as to the poor final results after ACL reconstruction [14]. Tegner et al recommended preoperative physiotherapy for 6 months before reconstruction of chronic ACL insufficiency [32], and this has been the most effective way of improving postoperative recovery [5,32].…”

Section: Discussionmentioning

confidence: 99%

Reconstruction of chronic anterior cruciate ligament insufficiency in athletes using a bone-patellar tendon-bone autograft

Järvinen

Natri

Lehto

et al. 1995

Thirty athletes (18 men and 12 women) were followed up for an average of 2.2 years after operative reconstruction for chronic anterior cruciate injuries with a mini-arthrotomy technique using a bone-patellar ligament-bone autograft. All the patients were active in sports, and the injuries in 40% occurred while playing soccer. The average delay between injury and reconstruction was 4.7 years; before this 26 knee operations had been carried out in 22 of the patients. At follow up, 20 patients were satisfied subjectively and 22 were classified objectively as excellent or good. Anteroposterior stability was good in 29 knees, and the Lachman and pivot shift tests were strongly positive in only one patient. Wasting of the thigh was more prominent in 9 patients who had a flexion deficit of 10 degrees or more, than in the other 21. Of the 15 competitive athletes, who had all given up their sport after injury, 8 were able to return to sport. Reconstruction using a bone-patellar ligament-bone autograft is recommended for symptomatic chronic anterior cruciate ligament insufficiency in athletes.