The Effect of Preoperative Quadriceps Strength on Strength and Function After Anterior Cruciate Ligament Reconstruction

Silkman, Carrie; McKeon, Jennifer M. Medina

doi:10.1123/jsr.21.1.89

Cited by 6 publications

(2 citation statements)

References 7 publications

(20 reference statements)

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“…The assumed association between objective and self-reported outcomes are supported by Logerstedt et al [ 39 ] providing evidence for the predictive value of the 6 months’ postoperative single-legged jump performance for the self-reported knee function one year after ACL surgery. Furthermore, evidence suggests the predictive value of preoperative neuromuscular performance for postoperative self-reported function and RTS [ 14 – 19 , 43 ].…”

Section: Discussionmentioning

confidence: 99%

“…One of these strategies is pre-operative rehabilitation (prehabilitation). Numerous studies indicate the relevance of preoperative neuromuscular performance factors, such as knee extension and flexion strength as well as single-leg-hop performance in ACL-injured individuals for postoperative knee function [ 14 – 19 ]. Accordingly, evidence-based guidelines for rehabilitation after ACLR also recommend pre-operative rehabilitation (prehabilitation) programmes with the aim to increase pre- and postoperative function [ 1 ].…”

Section: Introductionmentioning

confidence: 99%

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Evidence for the effects of prehabilitation before ACL-reconstruction on return to sport-related and self-reported knee function: A systematic review

et al. 2020

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Study design Systematic review. Background and objectives Preoperative neuromuscular function is predictive for knee function and return to sports (RTS) after reconstruction of the anterior cruciate ligament (ACL). The aim of this review was to examine the potential benefits of prehabilitation on pre-/postoperative objective, self-reported and RTS-specific outcomes. Methods A systematic search was conducted within three databases. From the 1.071 studies screened, two randomized control trials (RCTs), two control trials (CTs) and two cohort studies (CS) met the inclusion criteria. Methodological quality rating adopted the PEDro- (RCT, CT) or Newcastle-Ottawa-Scale (CS). Results and conclusions Methodological quality of the included studies was moderate (PEDro score: 6.5 ± 1.7; range 4 to 9). Two studies reported higher increases of the maximal quadriceps torque from baseline to pre-reconstruction: one study in the limb symmetry index (LSI), and one in both legs of the prehabilitation group compared to the controls. At 12-weeks post-reconstruction, one study (from two) indicated that the prehabilitation group had a lesser post-operative decline in the single-leg-hop for distance LSI (clinically meaningful). Similar findings were found in terms of quadriceps strength LSI (one study). At both pre-reconstruction (three studies) and two-year post-surgery (two studies), the prehabilitation groups reached significantly higher self-reported knee function (clinically meaningful) than the controls. RTS tended to be faster (one study). At two years post-surgery, RTS rates (one study) were higher in the prehabilitation groups. The results provide evidence for the relevance of prehabilitation prior to ACL-reconstruction to improve neuromuscular and self-reported knee function as well as RTS. More high quality confirmatory RCTs are warranted. Registration number PROSPERO 2017: CRD42017065491.

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