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. 2020 Dec 10;12(1):77.
doi: 10.1186/s13102-020-00222-8.

Recovery of preoperative absolute knee extension and flexion strength after ACL reconstruction

Ramana Piussi  1   2 , Daniel Broman  1 , Erik Musslinder  1 , Susanne Beischer  1   3 , Roland Thomeé  1   3 , Eric Hamrin Senorski  4   5   6
Affiliations

Recovery of preoperative absolute knee extension and flexion strength after ACL reconstruction

Ramana Piussi et al. BMC Sports Sci Med Rehabil. .

Abstract

Background: The recovery of muscle function after an Anterior Cruciate Ligament (ACL) reconstruction is most commonly reported as limb-to-limb differences using the Limb Symmetry Index (LSI), which is not free from limitations. The purpose of this study was to compare the proportion of patients who recover their Preoperative Absolute Muscle Strength (PAMS) 8 and 12 months after ACL reconstruction with the proportion of patients who recover their symmetrical knee strength. A secondary aim was to assess the relationship between psychological Patient-Reported Outcomes (PROs) and recovering PAMS at 8 and 12 months after ACL reconstruction and rehabilitation.

Method: Preoperative, 8- and 12-month results from quadriceps and hamstring strength tests and PROs for 117 patients were extracted from a rehabilitation registry. Individual preoperative peak torques from strength tests were compared with results from the 8- and 12-month follow-ups respectively. Patients were defined as having recovered their PAMS upon reaching 90% of their preoperative peak torque for both quadriceps and hamstring strength. Patients were defined as having recovered their LSI upon reaching a value ≥90% when comparing the results for their injured knee with those of their healthy knee. Correlations between the recovery of PAMS and PROs at 8 and 12 months were analyzed.

Results: There was no difference in the proportion of patients who recovered their PAMS compared with patients who recovered their LSI. In all, 30% and 32% of the patients who recovered their LSI had not recovered their PAMS at 8 months and 12 months respectively. In the patients who had recovered their PAMS, 24% and 31% had not recovered their symmetrical LSI at 8 months and 12 months respectively. There was no significant correlation between the recovery of PAMS and psychological PROs.

Conclusion: The use of both PAMS and LSI provides more detailed information on the recovery of muscle strength after ACL reconstruction. The recovery of PAMS was not correlated with psychological traits, which implies that both PROs and PAMS are important when evaluating patients after ACL reconstruction.

Trial registration: This trial was not registered.

Keywords: Anterior cruciate ligament; Evaluation; Knee; Limb symmetry index.

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Conflict of interest statement

The authors declare that they have no competing interests to declare.

Figures

Fig. 1
Fig. 1
Standardized warm-up procedure
Fig. 2
Fig. 2
Flowchart of included and excluded patients
Fig. 3
Fig. 3
Proportion of patients recovering their Limb Symmetry Index and Preoperative Absolute Muscle Strength
See this image and copyright information in PMC

References

    1. Abrams GD, Harris JD, Gupta AK, et al. Functional performance testing after anterior cruciate ligament reconstruction: a systematic review. Orthop J Sport Med. 2014;2(1):2325967113518305. doi: 10.1177/2325967113518305. - DOI - PMC - PubMed
    1. Almangoush A, Herrington L. Functional performance testing and patient reported outcomes following ACL reconstruction: a systematic scoping review. Int Scholar Res Notice. 2014;2014:613034. doi: 10.1155/2014/613034. - DOI - PMC - PubMed
    1. Ardern CL, Taylor NF, Feller JA, Whitehead TS, Webster KE. Sports participation 2 years after anterior cruciate ligament reconstruction in athletes who had not returned to sport at 1 year: a prospective follow-up of physical function and psychological factors in 122 athletes. Am J Sports Med. 2015;43(4):848–856. doi: 10.1177/0363546514563282. - DOI - PubMed
    1. Ashigbi EYK, Banzer W, Niederer D. Return to sport Tests' prognostic value for Reinjury risk after anterior cruciate ligament reconstruction: a systematic review. Med Sci Sports Exerc. 2020;52(6):1263–1271. doi: 10.1249/MSS.0000000000002246. - DOI - PubMed
    1. Aune AK, Holm I, Risberg MA, Jensen HK, Steen H. Four-strand hamstring tendon autograft compared with patellar tendon-bone autograft for anterior cruciate ligament reconstruction. A randomized study with two-year follow-up. Am J Sports Med. 2001;29(6):722–728. doi: 10.1177/03635465010290060901. - DOI - PubMed

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