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. 2014 Jul;6(4):309-12.
doi: 10.1177/1941738114537594.

Strength and functional performance recovery after anterior cruciate ligament reconstruction in preadolescent athletes

Elliot M Greenberg  1 , Eric T Greenberg  2 , Theodore J Ganley  3 , J Todd R Lawrence  4
Affiliations

Strength and functional performance recovery after anterior cruciate ligament reconstruction in preadolescent athletes

Elliot M Greenberg et al. Sports Health. 2014 Jul.

Abstract

Background: In the skeletally immature population, the incidence of anterior cruciate ligament (ACL) injuries and ACL reconstructions appears to be increasing. Differences in surgical techniques, physiology, and emotional maturity may alter the rehabilitation progression and impact the outcomes when compared with adults. Reports of objective strength recovery and performance-based outcome measures after pediatric ACL reconstruction (ACLR) are limited.

Study design: Retrospective case series.

Level of evidence: Level 4.

Methods: All patients that underwent all-epiphyseal ACLR from January 2008 to August 2010 were identified. Isokinetic peak quadriceps/hamstring torque values and functional performance measures in unilateral hopping tasks were extracted and compared with the noninjured limb. A limb symmetry index (LSI) of ≥90% was considered satisfactory.

Results: Complete data were available for 16 patients (mean age, 12.28 years; range, 8.51-14.88 years). By a mean 7 months (range, 3.02-12.56 years) postoperatively, only 9 of 16 (56%) were able to achieve a satisfactory LSI for quadriceps strength. For hamstring strength, 15 of 16 (94%) were able to achieve satisfactory LSI. By a mean of 12 months (range, 5.39-24.39 months) postoperatively, only 6 of 16 subjects (38%) were able to achieve satisfactory performance on all functional hop tests. At a mean 15.42 months (range, 8.58-24.39 months) postsurgery, only 4 of 16 (25%) subjects were able to achieve an LSI of ≥90% on all testing parameters.

Conclusion: For some pediatric patients, significant strength and functional deficits may be present at greater than 1 year after ACLR. This population may require more prolonged rehabilitation programs to allow for adequate recovery of strength and function because of unique characteristics of normal growth and development.

Keywords: anterior cruciate ligament; functional hop test; knee; pediatric; strength.

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Conflict of interest statement

The authors report no potential conflicts of interest in the development and publication of this article.

Institutional review board approval was obtained for all aspects of this study.

Figures

Figure 1.
Figure 1.
Schematic of the functional hop testing protocol.
Figure 2.
Figure 2.
Kaplan-Meier curves for not passing limb symmetry index (LSI) criteria of at least 90% on quadriceps isokinetic strength test.
See this image and copyright information in PMC

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