The natural history of donor hamstrings unit after anterior cruciate ligament reconstruction: a prospective MRI scan assessment

2015 ◽  
Vol 25 (5) ◽  
pp. 1583-1590 ◽  
Author(s):  
Ioannis Tsifountoudis ◽  
Ilias Bisbinas ◽  
Ioannis Kalaitzoglou ◽  
George Markopoulos ◽  
Aphrodite Haritandi ◽  
...  
2016 ◽  
Vol 51 (1) ◽  
pp. 22-27 ◽  
Author(s):  
John Goetschius ◽  
Joseph M. Hart

Context  When returning to physical activity, patients with a history of anterior cruciate ligament reconstruction (ACL-R) often experience limitations in knee-joint function that may be due to chronic impairments in quadriceps motor control. Assessment of knee-extension torque variability may demonstrate underlying impairments in quadriceps motor control in patients with a history of ACL-R. Objective  To identify differences in maximal isometric knee-extension torque variability between knees that have undergone ACL-R and healthy knees and to determine the relationship between knee-extension torque variability and self-reported knee function in patients with a history of ACL-R. Design  Descriptive laboratory study. Setting  Laboratory. Patients or Other Participants  A total of 53 individuals with primary, unilateral ACL-R (age = 23.4 ± 4.9 years, height = 1.7 ± 0.1 m, mass = 74.6 ± 14.8 kg) and 50 individuals with no history of substantial lower extremity injury or surgery who served as controls (age = 23.3 ± 4.4 years, height = 1.7 ± 0.1 m, mass = 67.4 ± 13.2 kg). Main Outcome Measure(s)  Torque variability, strength, and central activation ratio (CAR) were calculated from 3-second maximal knee-extension contraction trials (90° of flexion) with a superimposed electrical stimulus. All participants completed the International Knee Documentation Committee (IKDC) Subjective Knee Evaluation Form, and we determined the number of months after surgery. Group differences were assessed using independent-samples t tests. Correlation coefficients were calculated among torque variability, strength, CAR, months after surgery, and IKDC scores. Torque variability, strength, CAR, and months after surgery were regressed on IKDC scores using stepwise, multiple linear regression. Results  Torque variability was greater and strength, CAR, and IKDC scores were lower in the ACL-R group than in the control group (P < .05). Torque variability and strength were correlated with IKDC scores (P < .05). Torque variability, strength, and CAR were correlated with each other (P < .05). Torque variability alone accounted for 14.3% of the variance in IKDC scores. The combination of torque variability and number of months after surgery accounted for 21% of the variance in IKDC scores. Strength and CAR were excluded from the regression model. Conclusions  Knee-extension torque variability was moderately associated with IKDC scores in patients with a history of ACL-R. Torque variability combined with months after surgery predicted 21% of the variance in IKDC scores in these patients.


2018 ◽  
Vol 53 (9) ◽  
pp. 837-843 ◽  
Author(s):  
Christopher M. Kuenze ◽  
Stephanie Trigsted ◽  
Caroline Lisee ◽  
Eric Post ◽  
David R. Bell

Context:  After anterior cruciate ligament reconstruction (ACLR), women have a greater risk of incurring a second anterior cruciate ligament injury and they display different landing movement patterns than men. It remains unclear if clinical movement-assessment tools, such as the Landing Error Scoring System (LESS), can detect sex differences in movement patterns after ACLR. Objective:  To compare total LESS scores and individual LESS errors between men and women with a history of ACLR. Design:  Cross-sectional study. Setting:  Laboratory. Patients or Other Participants:  A total of 168 individuals (41 men and 127 women; mean age: men = 20 years [range, 19–25 years], women = 19 years [range, 18–20 years]; mean time since surgery: men = 21 months [range, 12–36 months], women = 27.5 months [range, 17–39 months]) with a history of primary, unilateral ACLR. Main Outcome Measure(s):  Participants completed a minimum of 3 trials of a drop vertical-jump task scored using the LESS. The between-sexes difference in LESS score was assessed using analysis of covariance, whereas the associations between participant sex and errors on each LESS item were assessed using logistic or multinomial regression. Results:  Women displayed a greater number of total landing errors (men = 4.6 ± 2.3, women = 6.1 ± 2.3; P < .001) and were more likely to commit errors in trunk flexion at initial contact (men = 4.9%, women = 23.6%; odds ratio [OR] = 4.94), medial knee position at initial contact (men = 17.1%, women = 42.5%; OR = 6.01), medial knee displacement (men = 24.4%, women = 73.2%; OR = 7.88), total joint displacement (1 error: men = 58.5%, women = 71.7%, OR = 2.10; 2 errors: men = 7.3%, women = 14.2%, OR = 3.71), and overall impression (1 error: men = 75.6%, women = 84.3%, OR = 3.24; 2 errors: men = 2.4%, women = 10.2%, OR = 12.89) compared with men. Conclusions:  Women with ACLR displayed worse LESS scores and were more likely to commit errors related to medial knee displacement and overall landing quality than men with ACLR.


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