Assessment of Post-Rehabilitation ACL Reconstructed Knees

Kevin Carlson

Abstract


Background: Understanding objective measures of ACL-reconstructed knee function is important in determining the efficacy of rehabilitation protocols and a patient’s return to activities of daily living and sport activities. Objective: To assess the range of motion (ROM), isokinetic strength (torque) and functional performance measures (hop test) of ACL-reconstructed and ACL-intact knees. Methods: Twelve volunteers (5 females, 7 males) with unilateral ACL injury and reconstruction were given a battery of tests (hop test for distance, knee range of motion, knee extensor isokinetic testing to assess both affected and unaffected lower limb function, flexibility and strength. Main effects and interactions were analyzed by mixed-model repeated measures ANCOVA. Dependent variables included hop test for distance, knee flexion and extension range of motion, and knee extensor isokinetic torque. The independent variables were the intact/reconstructed ACL knee and time from surgery. Sex was the covariate. Results: No statistically significant differences (p>0.05) were found across all dependent variables hop test for distance (P = 0.939), knee flexion (P = 0.576) and extension (P = 0.431) ROM, and knee extensor torque (eccentric P = 0.923 and concentric P = 0.723) for the main effects and interactions of knee (ACL-reconstructed and ACL-intact) and time (0-12 months, 13-24 months, 25-36 months and 37+ months). The covariate, sex, did produce significant differences for the hop test (P < 0.0001) and isokinetic testing (eccentric peak torque P = 0.003 and concentric peak torque P=0.012). Conclusions: Clinicians may consider present rehabilitation protocols to be adequate in developing ROM and isokinetic strength following ACL reconstruction. However, greater improvements in ROM and strength may be achieved over an extended period following ACL reconstruction surgery.

Keywords


Rehabilitation, Passive Range of Motion, Knee Joint, Torque, Anterior Cruciate Ligament, Therapeutics

Full Text:

PDF

References


Ageberg, E., Roos, H.P., Silbernagel, K.G., Thomee, R., & Roos, E.M. (2009). Knee extension and flexion muscle power after anterior cruciate ligament reconstruction with patellar tendon graft or hamstring tendons graft: a cross-sectional comparison 3 years post-surgery. Knee Surgery, Sports Traumatology, Arthroscopy, 17(2), 162-169. DOI: 10.1007/s00167-008-0645-4.

Almqvist, K.F., Willaert, P., DeBrabandere, S., Criel, K., & Verdonk, R. (2009). A long-term study of anterior cruciate ligament allograft reconstruction. Knee Surgery Sports Traumatology, Arthroscopy, 17(7), 818-822. DOI: 10.1007/s00167-009-0808-y.

Anderson, J. (2002). Changes in muscle torque following anterior cruciate ligament reconstruction: A comparison between hamstrings and patella tendon graft procedures on 45 patients. Acta Orthopaedica Scandinavia, 73(5), 546-552. DOI: 10.1080/000164702321022820.

Cavanaugh, J.T., & Powers, M. (2017). ACL rehabilitation progression: where are we now? Current Reviews in Musculoskeletal Medicine, 10(3), 289–296. DOI: 10.1007/s12178-017-9426-3

Chen, A.J., Tatarski, R.L., Perry, J., Quatman, C.E., Hewett, T.E., & DiStasi, S. (2020). Single-leg hop mechanics are correlated with self-reported knee function early after anterior cruciate ligament reconstruction, Clinical Biomechanics, 73, 35-45. DOI: 10.1016/j.clinbiomech.2019.12.2020.

Dauty, M., Tortellier, L., & Rochcongar, P. (2005). Isokinetic and anterior cruciate ligament reconstruction with hamstrings or patella tendon graft: analysis of literature. International Journal of Sports Medicine, 26(7), 599-606. DOI: 10.1055/s-2004-821342.

Davies, G.J., McCarty, E., Provencher, M., & Manske, R.C. (2017). ACL return to sport guidelines and criteria. Current Reviews in Musculoskeletal Medicine, 10(3), 307–314. DOI: 10.1007/s12178-017-9420-9.

de Mille, P., & Osmak, J. (2017). Performance: Bridging the Gap After ACL Surgery. Current Reviews in Musculoskeletal Medicine, 10(3), 297–306. DOI: 10.1007/s12178-017-9419-2.

Ernst, G.P., Saliba, E., Diduch, D.R., Hurwitz, S.R., & Ball, D.W. (2000). Lower-extremity compensations following anterior cruciate ligament reconstruction. Physical Therapy, 80(3), 251-260. DOI: 10.1093/ptj/80.3.251.

Filbay, S.R., Andersson, C., Ardern, C., Gauffin, H., & Kvist, J. (2018). Patient-reported outcome 32-37 years following surgically treated or non-surgically treated acute ACL injury. Osteoarthritis and Cartilage, 26(1), S52-S53. DOI: 10.1016/j.joca.2018.02.117.

Henry, J.C., & Kaeding, C. (2005). Neuromuscular differences between male and female athletes. Current Womens Health Reviews, 1(3), 241-244. PMID: 12112976.

Hiemstra, L. A., Webber, S., MacDonald, P. B., & Kriellaars, D. J. (2000). Knee strength deficits after hamstring tendon and patellar tendon anterior cruciate ligament reconstruction. Medicine and Science in Sports and Exercise, 32(8), 1472–1479. DOI: 10.1097/00005768-200008000-00016.

Keays, S. L., Bullock-Saxton, J., Keays, A. C., & Newcombe, P. (2001). Muscle strength and function before and after anterior cruciate ligament reconstruction using semitendonosus and gracilis. Knee, 8(3), 229–234. DOI: 10.1016/s0968-0160(01)00099-0.

Kvist J. (2004). Rehabilitation following anterior cruciate ligament injury: current recommendations for sports participation. Sports Medicine, 34(4), 269–280. DOI: 10.2165/00007256-200434040-00006.

Li, R. C., Maffulli, N., Hsu, Y. C., & Chan, K. M. (1996). Isokinetic strength of the quadriceps and hamstrings and functional ability of anterior cruciate deficient knees in recreational athletes. British Journal of Sports Medicine, 30(2), 161–164. DOI: 10.1136/bjsm.30.2.161.

Mansson, O., Sernert, N., & Kartus, J. T. (2014). Long-term course in adolescents after anterior cruciate ligament reconstruction. Orthopaedic Journal of Sports Medicine, 2(1 Suppl). DOI: 10.1177/2325967114S00006.

Matsumoto, H., Toyoda, T., Kawakubo, M., Otani, T., Suda, Y., & Fujikawa, K. (1999). Anterior cruciate ligament reconstruction and physiological joint laxity: earliest changes in joint stability and stiffness after reconstruction. Journal of Orthopaedic Science, 4(3), 191–196. DOI: 10.1007/s007760050093.

Mattacola, C. G., Perrin, D. H., Gansneder, B. M., Gieck, J. H., Saliba, E. N., & McCue, F. C., 3rd (2002). Strength, functional outcome, and postural stability after anterior cruciate ligament reconstruction. Journal of Athletic Training, 37(3), 262–268. PMID: 12937583

Moller, E., Weidenhielm, L., & Werner, S. (2009). Outcome and knee-related quality of life after anterior cruciate ligament reconstruction: a long-term follow-up. Knee Surgery, Sports Traumatology, Arthroscopy, 17, 786-794. DOI: 10.1007/s00167-009-0788-y.

Norkin, C.C. & White, D.J. (2017). Measurement of Joint Motion 5th. F.A. Davis Company.

Noyes, F.R., Barber, S.D., Mangine, R.E. (1991). Abnormal lower limb symmetry determined by function hop tests after anterior cruciate ligament rupture. American Journal of Sports Medicine, 19(5), 513-518. DOI: 10.1177/036354659101900518.

Oiestad, B. E., Holm, I., Aune, A. K., Gunderson, R., Myklebust, G., Engebretsen, L., Risberg, M. A. (2010). Knee function and prevalence of knee osteoarthritis after anterior cruciate ligament reconstruction: a prospective study with 10 to 15 years of follow-up. American Journal of Sports Medicine, 38(11), 2201–2210. DOI: 10.1177/0363546510373876

Risberg, M.A., Grindem, H., & Oiestad, B.E. (2016). We need to implement current evidence in early rehabilitation programs to improve long-term outcome after ACL injury. Journal of Orthopaedic and Sports Physical Therapy, 46(9), 710-713. DOI: 10.2519/jospt.2016.0608.

Sernert, N., Kartus, J., Köhler, K., Stener, S., Larsson, J., Eriksson, B. I., & Karlsson, J. (1999). Analysis of subjective, objective and functional examination tests after anterior cruciate ligament reconstruction. A follow-up of 527 patients. Knee Surgery, Sports Traumatology, Arthroscopy, 7(3), 160–165. DOI: 10.1007/s001670050141.

Simonsen, E. B., Magnusson, S. P., Bencke, J., Naesborg, H., Havkrog, M., Ebstrup, J. F., & Sørensen, H. (2000). Can the hamstring muscles protect the anterior cruciate ligament during a side-cutting maneuver? Scandinavian Journal of Medicine and Science in Sports, 10(2), 78–84. DOI: 10.1034/j.1600-0838.2000.010002078.

Stein, S.M., & Mandelbaum, B.R. (2019). Editorial Commentary: Anterior cruciate ligament injury and reconstruction in soccer players: the major challenge is always going for our goals. Arthroscopy, 36(1), 196-198. DOI: 10.1016/j.arthro.2019.10.005.

The MOON Knee Group. (2018). Ten year outcomes and risk factors after anterior cruciate ligament reconstruction. American Journal of Sports Medicine, 46(4), 815-825. DOI: 10.1177/0363546517749850.




DOI: https://doi.org/10.7575//aiac.ijkss.v.8n.2p.33

Refbacks

  • There are currently no refbacks.


Bookmark and Share


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.

2013-2023 (CC-BY) Australian International Academic Centre PTY.LTD.

International Journal of Kinesiology and Sports Science

You may require to add the 'aiac.org.au' domain to your e-mail 'safe list’ If you do not receive e-mail in your 'inbox'. Otherwise, you may check your 'Spam mail' or 'junk mail' folders.