Differences in Isokinetic Strength of the Knee Extensors and Flexors in Men With Isolated and Combined Cruciate-Ligament Knee Injury

2015 ◽  
Vol 24 (3) ◽  
pp. 268-277 ◽  
Author(s):  
Ewa Kaminska ◽  
Tomasz Piontek ◽  
Marzena Wiernicka ◽  
Grazyna Cywinska-Wasilewska ◽  
Jacek Lewandowski ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Outcome Measures ◽  
Body Mass ◽  
Cruciate Ligament ◽  
Knee Extension ◽  
Ligament Injury ◽  
Knee Extensors ◽  
Isokinetic Testing ◽  
Ligament Tear ◽  
Anterior Cruciate

Context:The extent of knee extensor and flexor weakness after disruption of knee ligaments affects a rehabilitation output and functional recovery and may give prognostic information on a possible risk of development of knee osteoarthritis.Objective:The hypothesis tested was whether patients with a multiple-ligament tear would have larger abnormalities in strength of the knee extensors and flexors than patients with an isolated-ligament rupture.Design:Cross-sectional study, level III.Setting:Outpatient orthopedic clinic.Participants:3 groups of recreationally active men: noninjured control (CON, n = 12), with an anterior cruciate ligament injury (ACLI, n = 10), and with combined anterior and posterior cruciate ligament injury (APCLI, n = 9), matched according to age, body mass, and height.Intervention:All patients received conservative treatment and rehabilitation and awaited ligament reconstruction surgery.Main Outcome Measures:Isokinetic maximum-repetition peak torque per body mass (PT/BM) and total work (TW), PT and TW limb-symmetry index (LSI), and flexor-to-extensor PT ratio were evaluated during concentric knee extension-flexion movements at lower (60°/s) and higher (240°/s) isokinetic velocities.Results:The main finding was that compared with the individuals with ACLI, patients with APCLI produced in their injured limbs lower mean TW (extension: 30.3%, flexion: 28.2%) and had lower mean TW LSI (extension 74% in APCLI vs 91.6% in ACLI; flexion 61.3% in APCLI vs 90.8% in ACLI) at the higher but not lower speed of isokinetic testing. However, at the lower velocity the quantified size of reduction in PT/BM and TW was greater in subjects with APCLI than ACLI as compared with the CON individuals.Conclusions:After bi-cruciate-ligament injury the capacity to produce torque by concentric muscle contractions throughout knee-extension and-flexion movements performed with high speed is lower in injured limbs than after isolated anterior cruciate ligament tear.

scholarly journals Predictive Factors Associated with Anterolateral Ligament Injury in the Patients with Anterior Cruciate Ligament Tear

2020 ◽  
Vol 54 (5) ◽  
pp. 655-664
Author(s):  
Iraj Shekari ◽  
Babak Shekarchi ◽  
Mohammadreza Abbasian ◽  
Mohammadreza Minator Sajjadi ◽  
Amin Momeni Moghaddam ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Predictive Factors ◽  
Cruciate Ligament ◽  
Anterolateral Ligament ◽  
Ligament Injury ◽  
Anterior Cruciate Ligament Tear ◽  
Ligament Tear ◽  
Factors Associated ◽  
Anterior Cruciate

Intra-articular and meniscal pathology according to anterior cruciate ligament injury pattern: both-bundle tear or selective bundle tear

2019 ◽  
Vol 61 (5) ◽  
pp. 644-650
Author(s):  
Jin Hee Park ◽  
Hee Jin Park ◽  
So Yeon Lee ◽  
Hyun Pyo Hong ◽  
Soo Youn Ham ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Anterior Cruciate Ligament Injury ◽  
Cruciate Ligament ◽  
Meniscal Tear ◽  
Cartilage Injury ◽  
Ligament Injury ◽  
Anterior Cruciate Ligament Tear ◽  
Meniscal Injury ◽  
Ligament Tear ◽  
Anterior Cruciate

Background Articular cartilage injury and meniscal tear are usually combined with anterior cruciate ligament injury. Purpose We investigated the incidence of cartilage injury and traumatic meniscal tear according to the type of combined anterior cruciate ligament tear (both-bundle versus selective bundle tear). Material and Methods This retrospective study included 103 patients diagnosed with anterior cruciate ligament tear after knee joint magnetic resonance imaging and who underwent knee joint arthroscopy. Two radiologists evaluated articular cartilage injuries and meniscal tear independently. We used the chi-square test to analyze the association between type of anterior cruciate ligament bundle tear and presence of cartilage or meniscal injury in each reader. Results Cartilage injury presented a significantly higher prevalence in both-bundle tear than did selective bundle tear in reader 1 ( P = 0.004). In reader 2, both-bundle tear had a tendency for higher risk of cartilage injury, but this was not statistically significant ( P = 0.178). In meniscal injury, there was a statistically significant increase in the risk of associated meniscal injury in both-bundle tear versus selective bundle anterior cruciate ligament injury ( P = 0.019 and 0.021). The risk of accompanying traumatic meniscal lesion was significantly higher in both-bundle tear ( P = 0.036 and 0.018). Conclusion The incidence of accompanying meniscal injury, especially traumatic tears, is higher in both-bundle anterior cruciate ligament tear than in selective bundle tear. There was no significant difference in incidence of cartilage injury between both-bundle tear and selective bundle tear, although one of two readers showed a higher incidence in both-bundle tear.

scholarly journals Unilateral Quadriceps Strengthening With Disinhibitory Cryotherapy and Quadriceps Symmetry After Anterior Cruciate Ligament Reconstruction

2017 ◽  
Vol 52 (11) ◽  
pp. 1010-1018 ◽  
Author(s):  
Christopher M. Kuenze ◽  
Adam R. Kelly ◽  
Hyung-Pil Jun ◽  
Moataz Eltoukhy
Keyword(s):  
Body Mass Index ◽  
Anterior Cruciate Ligament ◽  
Anterior Cruciate Ligament Reconstruction ◽  
Body Mass ◽  
Ligament Reconstruction ◽  
Cruciate Ligament ◽  
Knee Extension ◽  
Cruciate Ligament Reconstruction ◽  
Anterior Cruciate ◽  
Quadriceps Function

Context:  The effect of unilateral cryotherapy-facilitated rehabilitation exercise on involved-limb quadriceps function and limb symmetry in individuals with quadriceps dysfunction after anterior cruciate ligament reconstruction (ACLR) remains unclear. Objective:  To measure the effect of a 2-week unilateral cryotherapy-facilitated quadriceps-strengthening program on knee-extension strength and quadriceps central activation ratio (CAR) in participants with ACLR. Design:  Controlled laboratory study. Setting:  Laboratory. Patients or Other Participants:  A total of 10 volunteers with unilateral ACLR (1 man, 9 women; age = 21.0 ± 2.8 years, height = 164.6 ± 5.0 cm, mass = 64.0 ± 6.1 kg, body mass index = 23.7 ± 2.7 kg/m2) and 10 healthy volunteers serving as control participants (1 man, 9 women; age = 20.8 ± 2.5 years, height = 169.1 ± 6.2 cm, mass = 61.1 ± 6.4 kg, body mass index = 21.4 ± 2.3 kg/m2) participated. Intervention(s):  Participants with ACLR completed a 2-week unilateral cryotherapy-facilitated quadriceps-strengthening intervention. Main Outcome Measure(s):  Bilateral normalized knee-extension maximal voluntary isometric contraction (MVIC) torque (Nm/kg) and quadriceps CAR (%) were assessed preintervention and postintervention. Limb symmetry index (LSI) was calculated at preintervention and postintervention testing. Preintervention between-groups differences in unilateral quadriceps function and LSI were evaluated using independent-samples t tests. Preintervention-to-postintervention differences in quadriceps function were evaluated using paired-samples t tests. Cohen d effect sizes (95% confidence interval [CI]) were calculated for each comparison. Results:  Preintervention between-groups comparisons revealed less knee-extension MVIC torque and quadriceps CAR for the ACLR limb (MVIC: P = .01, Cohen d = −1.31 [95% CI = −2.28, −0.34]; CAR: P = .004, Cohen d = −1.48 [95% CI = −2.47, −0.49]) and uninvolved limb (MVIC: P = .03, Cohen d = −1.05 [95% CI = −1.99, −0.11]; CAR: P = .01, Cohen d = −1.27 [95% CI = −2.23, −0.31]) but not for the LSI (MVIC: P = .46, Cohen d = −0.34 [95% CI = −1.22, 0.54]; CAR: P = .60, Cohen d = 0.24 [95% CI = −0.64, 1.12]). In the ACLR group, participants had improved knee-extension MVIC torque in the involved limb (P = .04, Cohen d = 0.32 [95% CI = −0.56, 1.20]) and uninvolved limb (P = .03, Cohen d = 0.29 [95% CI = −0.59, 1.17]); however, the improvement in quadriceps CAR was limited to the involved limb (P = .02, Cohen d = 1.16 [95% CI = 0.21, 2.11]). We observed no change in the LSI with the intervention for knee-extension MVIC torque (P = .74, Cohen d = 0.09 [95% CI = −0.79, 0.97]) or quadriceps CAR (P = .61, Cohen d = 0.26 [95% CI = −0.62, 1.14]). Conclusions:  Two weeks of cryotherapy-facilitated exercise may improve involved-limb quadriceps function while preserving between-limbs symmetry in patients with a history of ACLR.

scholarly journals Lower-Extremity Compensations Following Anterior Cruciate Ligament Reconstruction

2000 ◽  
Vol 80 (3) ◽  
pp. 251-260 ◽  
Author(s):  
Gregory P Ernst ◽  
Ethan Saliba ◽  
David R Diduch ◽  
Shepard R Hurwitz ◽  
Donald W Ball
Keyword(s):  
Anterior Cruciate Ligament ◽  
Lower Extremity ◽  
Cruciate Ligament ◽  
Vertical Jump ◽  
Weight Bearing ◽  
Knee Extension ◽  
Isokinetic Testing ◽  
Anterior Cruciate ◽  
Platform System ◽  
Femoris Muscle

AbstractBackground and Purpose. Several studies have demonstrated that patients with knee injury scored within a normal range during one-legged hop tests yet showed quadriceps femoris muscle weakness with non–weight-bearing isokinetic testing. This study evaluated lower-extremity kinetics while subjects performed a single-leg vertical jump (VJ) and a lateral step-up (LSU) in an attempt to explain this phenomenon. Subjects and Methods. Using a motion analysis and force platform system, hip, knee, and ankle extension moments of 20 subjects with anterior cruciate ligament (ACL) reconstructions and 20 matched subjects were measured while they performed an LSU and a VJ. Results. An analysis of variance revealed that the knee extension moment of the ACL-reconstructed extremity was lower than that of the uninjured and matched extremities during the LSU, VJ take-off, and VJ landing. However, there was no difference in summated extension moment (hip + knee + ankle) among extremities during the LSU and VJ take-off. The summated extension moment of the ACL-reconstructed extremity during VJ landing was less than that of the uninvolved and matched extremities. Conclusions and Discussion. These results suggest that the hip or ankle extensors may compensate for the knee extension moment deficit. The decrease in summated extension moment in the ACL-reconstructed extremity during VJ landing represents inadequate attenuation of landing forces, which may expose the skeleton and joint structures to injury.

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