Traditional and Additional Isokinetic Knee Strength Assessments of Athletes; Post-Operative Results of Hamstring Autograft ACL Reconstruction

Abstract

Background and Objectives: Anterior cruciate ligament (ACL) injuries are common injuries in athletes, and, accordingly, ACL reconstruction (ACLR) is one of the most common orthopedic surgical procedures performed on athletes. This study aims to compare the 6-month post-operative isokinetic knee strength evaluations of the semitendinous/gracilis (ST/G) ACLR technique performed on healthy (HK) and ACLR knees of athletes. Materials and Methods: A retrospective cohort of 29 athletes from various sports branches who underwent ST/G ACLR technique by the same surgeon were evaluated. The isokinetic knee extension (Ex) and flexion (Flx) strength of the patients on the HK and ACLR sides were evaluated with a series consisting of three different angular velocities (60, 180, and 240°/s). In addition to the traditional evaluations of peak torque (PT) and hamstring/quadriceps (H/Q) parameters, the findings were also evaluated with additional parameters such as the joint angle at peak torque (JAPT), time to peak torque (TPT), and reciprocal delay (RD). Results: There was a significant improvement in the mean Lysholm, Tegner, and IKDC scores after surgery compared with preoperative levels (p < 0.05). As for the isokinetic PT values, there were significant differences in favor of HK in the 60°/s Flx, 180°, and 240°/s Ex phases (p < 0.05). In addition, there was a significant difference in the 60° and 180°/s Flx phases in RD (p < 0.05). In H/Q ratio, TPT, and JAPT values, no significant difference was observed between HK and ACLR at all angular velocities. Conclusions: The findings showed that the ST/G 6-month post-operative isokinetic knee strength in athletes produced high results in HK, and, when evaluated in terms of returning to sports, the H/Q ratios on the ACLR side were sufficient to make the decision to return to sports. It was found that the ACLR side was slower than the HK side in the reciprocal transitions, particularly in the Flx phase. We believe that this results from the deformation of the hamstring muscle after reconstruction of the ST/G ACLR side.

Keywords: anterior cruciate ligament reconstruction; athletes; isokinetic evaluations; return to sports.

Figure 1

Comparison of PT values obtained in isokinetic tests for HK and ACLR. ns, nonsignificant; * p < 0.05; HK, healthy knee; ACLR, anterior cruciate ligament reconstruction knee; Ex, extension; Flx, flexion.

Figure 2

Comparison of H/Q ratios obtained in isokinetic tests for HK and ACLR. ns, nonsignificant; HK, healthy knee; ACLR, anterior cruciate ligament reconstruction knee; H/Q, hamstring/quadriceps.

Figure 3

Comparison of JAPT values obtained in isokinetic tests for HK and ACLR. ns, nonsignificant; HK, healthy knee; ACLR, anterior cruciate ligament reconstruction knee.

Figure 4

Comparison of TPT and RD values obtained in isokinetic tests for HK and ACLR. ns, nonsignificant; * p < 0.05; HK, healthy knee; ACLR, anterior cruciate ligament reconstruction knee; H/Q, hamstring/quadriceps; Ex, extension; Flx, flexion.