scholarly journals Laxity measurement of internal knee rotation after primary anterior cruciate ligament rupture versus rerupture

2021 ◽  
Author(s):  
Hermann O. Mayr ◽  
Georg Hellbruegge ◽  
Florian Haasters ◽  
Bastian Ipach ◽  
Hagen Schmal ◽  
...  
Keyword(s):  
Internal Rotation ◽  
Cruciate Ligament ◽  
Cross Sectional Study ◽  
Acl Rupture ◽  
Sectional Study ◽  
Rotational Laxity ◽  
Cross Sectional ◽  
Anterior Cruciate ◽  
Ikdc 2000 ◽  
Tegner Activity Scale

Abstract Purpose The aim of the current study was to objectify the rotational laxity after primary anterior cruciate ligament (ACL) rupture and rerupture after ACL reconstruction by instrumented measurement. It was hypothesized that knees with recurrent instability feature a higher internal rotation laxity as compared to knees with a primary rupture of the native ACL. Study design Cross-sectional study, Level of evidence III. Methods In a clinical cross-sectional study successive patients with primary ACL rupture and rerupture after ACL reconstruction were evaluated clinically and by instrumented measurement of the rotational and antero-posterior laxity with a validated instrument and the KT1000®, respectively. Clinical examination comprised IKDC 2000 forms, Lysholm Score, and Tegner Activity Scale. Power calculation and statistical analysis were performed (p value < 0.05). Results 24 patients with primary ACL rupture and 23 patients with ACL rerupture were included. There was no significant side-to-side difference in anterior translation. A side-to side difference of internal rotational laxity ≥ 10° was found significantly more frequent in reruptures (53.6%) compared to primary ruptures (19.4%; p < 0.001). A highly significant relationship between the extent of the pivot-shift phenomenon and side-to-side difference of internal rotation laxity could be demonstrated (p < 0.001). IKDC 2000 subjective revealed significantly better scores in patients with primary ACL tear compared to patients with ACL rerupture (56.4 ± 7.8 vs. 50.8 ± 6.2; p = 0.01). Patients with primary ACL tears scored significantly better on the Tegner Activity Scale (p = 0.02). No significant differences were seen in the Lysholm Score (p = 0.78). Conclusion Patients with ACL rerupture feature significantly higher internal rotation laxity of the knee compared to primary ACL rupture. The extend of rotational laxity can be quantified by instrumented measurements. This can be valuable data for the indication of an anterolateral ligament reconstruction in ACL revision surgery.

Rate of Force Development Remains Reduced in the Knee Flexors 3 to 9 Months After Anterior Cruciate Ligament Reconstruction Using Medial Hamstring Autografts: A Cross-Sectional Study

2020 ◽  
Vol 48 (13) ◽  
pp. 3214-3223
Author(s):  
Jakob Lindberg Nielsen ◽  
Kamilla Arp ◽  
Mette Lysemose Villadsen ◽  
Stine Sommer Christensen ◽  
Per Aagaard
Keyword(s):  
Functional Capacity ◽  
Cruciate Ligament ◽  
Knee Extensor ◽  
Cross Sectional Study ◽  
Healthy Controls ◽  
Sectional Study ◽  
Cross Sectional ◽  
Force Development ◽  
Anterior Cruciate ◽  
Maximal Muscle Strength

Background: Anterior cruciate ligament (ACL) rupture is a serious injury with a high prevalence worldwide, and subsequent ACL reconstructions (ACLR) appear to be most commonly performed using hamstring-derived (semitendinosus tendon) autografts. Recovery of maximal muscle strength to ≥90% of the healthy contralateral limb is considered an important criterion for safe return to sports. However, the speed of developing muscular force (ie, the rate of force development [RFD]) is also important for the performance of many types of activities in sports and daily living, yet RFD of the knee extensor and flexor muscles has apparently never been examined in patients who undergo ACLR with hamstring autograft (HA). Purpose: To examine potential deficits in RFD, maximal muscle strength (ie, maximal voluntary isometric contraction [MVIC]), and functional capacity of ACLR-HA limbs in comparison with the healthy contralateral leg and matched healthy controls 3 to 9 months after surgery. Study Design: Cross-sectional study; Level of evidence: 3. Methods: A total of 23 young patients who had undergone ACLR-HA 3 to 9 months earlier were matched by age to 14 healthy controls; both groups underwent neuromuscular screening. Knee extensor and flexor MVIC and RFD, as well as functional capacity (single-leg hop for distance [SLHD] test, timed single-leg sit-to-stand [STS] test), were assessed on both limbs. Furthermore, patient-reported knee function (Knee injury and Osteoarthritis Outcome Score) was assessed. Results: Knee extensor and flexor MVIC and RFD were markedly compromised in ACLR-HA limbs compared with healthy contralateral limbs (MVIC for extensor and flexor, 13% and 26%, respectively; RFD, 14%-17% and 32%-39%) and controls (MVIC, 16% and 31%; RFD, 14%-19% and 30%-41%) ( P < .05-.001). Further, ACLR-HA limbs showed reduced functional capacity (reduced SLHD and STS performance) compared with contralateral limbs (SLHD, 11%; STS, 14%) and controls (SLHD, 20%; STS, 31%) ( P < .01-.001). Strength (MVIC) and functional (SLHD) parameters were positively related to the duration of time after surgery ( P < .05), although this relationship was not observed for RFD and STS. Conclusion: Knee extensor and flexor RFD and maximal strength, as well as functional single-leg performance, remained substantially reduced in ACLR-HA limbs compared with noninjured contralateral limbs and healthy controls 3 to 9 months after reconstructive surgery.

scholarly journals Association Between Knee Moments During Stair Navigation and Participant-Related Factors in Individuals With Anterior Cruciate Ligament Reconstruction: A Cross-Sectional Study

2021 ◽  
pp. 1-7
Author(s):  
Mandeep Kaur ◽  
Daniel Cury Ribeiro ◽  
Kate E. Webster ◽  
Gisela Sole
Keyword(s):  
Muscle Strength ◽  
Knee Flexion ◽  
Ligament Reconstruction ◽  
Cruciate Ligament ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Related Factors ◽  
Cross Sectional ◽  
Stair Ascent ◽  
Anterior Cruciate

Context: Altered knee joint mechanics may be related to quadriceps muscle strength, time since surgery, and sex following anterior cruciate ligament reconstruction (ACLR). The aim of this study was to investigate the association between knee moments, with participant-related factors during stair navigation post-ACLR. Design: Cross-sectional study. Methods: A total of 30 participants (14 women) with ACLR, on average 7.0 (SD 4.4) years postsurgery were tested during stair ascent and descent in a gait laboratory. Motion capture was conducted using a floor-embedded force plate and 11 infrared cameras. Quadriceps concentric and eccentric muscle strength was measured with an isokinetic dynamometer at 60°/s, and peak torques recorded. Multiple regression analyses were performed between external knee flexion and adduction moments, respectively, and quadriceps peak torque, sex, and time since ACLR. Results: Higher concentric quadriceps strength and female sex accounted for 55.7% of the total variance for peak knee flexion moment during stair ascent (P < .001). None of the independent variables accounted for variance in knee adduction moment (P = .698). No significant associations were found for knee flexion and adduction moments during for stair descent. Conclusion: Higher quadriceps concentric strength and sex explains major variance in knee flexion moments during stair ascent. The strong association between muscle strength and external knee flexion moments during stair ascent indicate rehabilitation tailored for quadriceps may optimize knee mechanics, particularly for women.

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