Muscular isokinetic strength recovery after knee anterior cruciate ligament reconstruction revision: preliminary study

Abstract

Method: Thirty-nine revision of ACL reconstructions were evaluated: 23 primary ACL reconstructions with bone-patellar tendon-bone graft (BPTB) revised with hamstring tendon (HT) grafts, 10 primary ACL reconstructions with HT grafts revised with ipsilateral BPTB graft (iBPTB) and finally 6 primary ACL reconstructions with BPTB grafts revised with contralateral BPTB (cBPTB) grafts were compared with 78 primary ACL reconstructions (46 HT grafts and 32 BPTB grafts). Recovery of isokinetic muscle strength was evaluated at 4, 6 and 12 months post-revision surgery.

Results: Deficits in muscle strength at 12 months post-revision ACL surgery were comparable to the one observed for primary ACL reconstruction with the same technique. At 4 and 6 months post-surgery, strength deficits for the knee extensors were less pronounced after revision ACL reconstruction with HT grafts (25%±16 vs. 37%±16; P<0.001) and iBPTB grafts (41%±11 vs. 17%±17; P<0.001).

Discussion: Lower strength deficits for the knee extensors after revision ACL reconstruction with HT grafts can be explained by a less intensive rehabilitation program due to lower stakes in resuming sport activities. With cBPTB, donor-site morbidity could explain the decreased strength deficits for knee extensors.

Conclusion: Deficits in isokinetic muscle strength after ACL revision seem similar to the ones observed after primary ACL reconstruction with the same surgical technique.

Keywords: Anterior cruciate ligament reconstruction; Isocinétique; Isokinetic; Reconstruction du ligament croisé antérieur; Reprise; Revision.