Recovery of Preoperative Absolute Knee Extension and Flexion Strength After ACL Reconstruction

Overview

Journal BMC Sports Sci Med Rehabil

Publisher Biomed Central

Specialty Orthopedics

Date 2020 Dec 11

PMID 33302996

Citations 9

Authors

Ramana Piussi

Daniel Broman

Erik Musslinder

Susanne Beischer

Roland Thomee

Eric Hamrin Senorski

Affiliations

Soon will be listed here.

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.

Citing Articles

Questioning the rules of engagement: a critical analysis of the use of limb symmetry index for safe return to sport after anterior cruciate ligament reconstruction.

Simonsson R, Sundberg A, Piussi R, Hogberg J, Senorski C, Thomee R Br J Sports Med. 2025; 59(6):376-384.

PMID: 39797641 PMC: 11874420. DOI: 10.1136/bjsports-2024-108079.

Effects of Blood Flow Restriction Training in Patients before and after Anterior Cruciate Ligament Reconstruction: A Systematic Review and Meta-Analysis.

Fraca-Fernandez E, Ceballos-Laita L, Hernandez-Lazaro H, Jimenez-Del-Barrio S, Mingo-Gomez M, Medrano-de-la-Fuente R Healthcare (Basel). 2024; 12(12).

PMID: 38921345 PMC: 11203215. DOI: 10.3390/healthcare12121231.

Relationship between hamstring strength and hop performance at 8 and 12 months after ACL reconstruction with hamstring tendon autografts.

Hogberg J, Lindskog J, Sundberg A, Piussi R, Simonsson R, Samuelsson K BMC Sports Sci Med Rehabil. 2024; 16(1):134.

PMID: 38890724 PMC: 11184683. DOI: 10.1186/s13102-024-00923-4.

No Association Between Hamstrings-to-Quadriceps Strength Ratio and Second ACL Injuries After Accounting for Prognostic Factors: A Cohort Study of 574 Patients After ACL-Reconstruction.

Hogberg J, Piussi R, Wernbom M, Della Villa F, Simonsson R, Samuelsson K Sports Med Open. 2024; 10(1):7.

PMID: 38212594 PMC: 10784243. DOI: 10.1186/s40798-023-00670-9.

A comparison between physical therapy clinics with high and low rehabilitation volumes of patients with ACL reconstruction.

Simonsson R, Hogberg J, Lindskog J, Piussi R, Sundberg A, Sansone M J Orthop Surg Res. 2023; 18(1):842.

PMID: 37936163 PMC: 10629052. DOI: 10.1186/s13018-023-04304-4.

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