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ISSN 2992-8036 (Electronic)
ISSN 2306-4102 (Print)
Órgano Oficial del Colegio Mexicano de Ortopedia y Traumatología

2009, Number 5

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Acta Ortop Mex 2009; 23 (5)

Isokinetic assessment post-ACL reconstruction: comparison of the semitendinous/gracilis and bone-tendon-bone techniques

Figueroa PD, Meleán QP , Calvo RR, Vaisman BA, Figueroa BF, Calvo CC

Language: Spanish
References: 36
Page: 266-271
PDF size: 71.27 Kb.


ABSTRACT

The purpose of this study is to detect the differences in the isokinetic assessment after anterior cruciate ligament (ACL) reconstruction with the bone-patellar tendon-bone (BTB) and semitendinous/gracilis (STG) techniques. Methods: Ninety-five patients with a minimum follow-up of six months were assessed with a Cybex 6000 dynamometer during concentric contraction at 60°/s. The BTB technique was used in 27 patients and the STG technique in 68. The ANOVA and Pearson tables were used to analyze the flexion and extension strength deficit, peak torque (PT) strength in flexion and extension (Nm) and the muscle balance. Results: Mean loss of strength in flexion was 18.82% with BTB and 11.05% with STG (p = 0.04). Mean loss of strength in extension was 24.04% with BTB and 17.1% with STG (p = 0.75). The mean PT strength in flexion was 113.2 Nm (38-203) for BTB and 128.4 Nm (73-219) for STG (p = 0.603). The mean PT strength in extension was 187.2 Nm (68-363) for BTB and 194 Nm (107-339) for STG (p = 0.102). The mean muscle balance was 73.4% for STG and 68.6% for BTB (p = 0.961). Conclusion: The flexion strength was more compromised after BTB reconstruction compared to the STG procedure. We documented a trend towards loss of PT strength in flexion and extension and muscle balance with flexor predominance post-BTB reconstruction.


REFERENCES

  1. Larson R: Anterior cruciate ligament insufficiency: Principles of treatment. J Am Acad Orthop Surg 1994; 2: 26-35.

  2. Garrandes F, Colson SS, Parisaux J-M, et al: Knee isometric torque and electromyographic specificities after semitendinosus and gracilis hamstrings anterior cruciate ligament reconstruction. Am J Phys Med Rehab 2006; (85)2: 127-34.

  3. Feagin JA Jr, Curl WW: Isolated tear of the anterior cruciate ligament: 5-year follow-up study. Am J Sports Med 1976; 4: 95-100.

  4. Palmer I: The classic: On the injuries to the ligaments of the knee joint: A clinical study. Clin Ortho Rel Res 2007; 454: 17-22.

  5. Andersson C, Odensten M, Gillquist J: Knee function after surgical or nonsurgical treatment of acute rupture of the anterior cruciate ligament: A randomized study with a long-term follow-up period. Clin Ortho Rel Res 1991; 264: 255-63.

  6. Shelbourne KD, Wilckens JH: Current concepts in anterior cruciate ligament rehabilitation. Orthop Rev 1990; 19(11): 957-64.

  7. Beynnon BD, Uh BS, Johnson RJ, et al: Rehabilitation after anterior cruciate ligament reconstruction: a prospective, randomized, double-blind comparison of programs administered over 2 different time intervals. Am J Sports Med 2005; 33: 347-59.

  8. Carter T, Edinger S: Isokinetic evaluation of anterior cruciate ligament reconstruction: Hamstring versus patellar tendon. Arthroscopy. 1999; 2: 169-72.

  9. Hugel M, Indelicato P: Trends in rehabilitation following anterior cruciate ligament reconstruction. Clin Sports Med 1988; 7: 801-11.

  10. Wilk KE: Anterior cruciate ligament reconstruction rehabilitation: A six-month follow up of isokinetic testing in recreational athletes. Isokinet Exerc Sci 1991; 1: 36-43.

  11. Terreri A: Isokinetic assessment of the flexor-extensor balance of the knee in athletes with total rupture of the anterior cruciate ligament. Rev Hosp Clín Fac Med Sao Paulo 1999: 54(2): 35-8.

  12. Campbell D, Glenn W: Rehabilitation of knee flexor and extensor muscle strength in patients with meniscectomies, ligamentous repairs, and chondromalacia. Physical Therapy 1982; 62: 10-5.

  13. Kellis E, Baltzopoulos V: Isokinetics excentric exercise. Sports Med 1995; 19: 202-22.

  14. Thorsten R: Functional capability is enhanced with semitendinosus than patellar tendon ACL repair. Medicine & Science in Sports & Exercise 2003; 1: 1486-92.

  15. Draganich LF, Jaeger RJ, Kralj AR: Coactivation of the hamstrings and quadriceps during extension of the knee. J Bone Joint Surg Am 1989; 71: 1075-81.

  16. Aglietti P, Buzzi R, Zaccerotti G: Patellar tendon versus doubled semitendinosus and gracilis tendons for anterior cruciate ligament reconstruction. Am J Sports Med 1994; 22: 211-7.

  17. Corry I, Webb J: Arthroscopic reconstruction of the anterior cruciate ligament: a comparison of patellar tendon autograft and four-strand hamstring tendon autograft. Am J Sport Med 1999; 27: 444-54.

  18. Doral M, Atay A: Arthroscopy-assisted anterior cruciate ligament reconstruction with patellar tendon or hamstring autografts. Bull Hosp Joint Dis 2000; 59: 81-7.

  19. Natri A, Jarvinen M, Latuala K, et al: Isokinetic muscle performance after anterior cruciate ligament surgery. Int J Sports Med 1996; 17: 223-8.

  20. Marder RA, Raskind JR, Carrol M: Prospective evaluation of arthroscopically assisted anterior cruciate ligament reconstruction. Am J Sports Med 1991; 19: 478-83.

  21. Bach BR Jr, Jones GT, Sweet FA, et al: Arthroscopy-assisted anterior cruciate ligament reconstruction using patellar tendon substitution. Am J Sports Med 1994; 22: 758-67.

  22. Saddemi SR, Frogameni AD, Fenton PJ: Comparison of perioperative morbidity of anterior cruciate ligament autografts versus allografts. Arthroscopy 1993; 9: 519-24.

  23. Glancy WG: Acute tears of the anterior cruciate ligament. Surgical versus conservative treatment. J Bone Joint Surg Am 1988; 70: 1483-8.

  24. McDaniel W, Dameron T: Untreated ruptures of the anterior cruciate ligament. A follow up study. JBJS 1980; 62A(4): 696-705.

  25. Webb J, Corry I: Injuries of the sporting knee. Br J Sports Med 2000; 34: 227.

  26. Bollen S: Epidemiology of knee injuries: diagnosis and triage. Br J Sports Med 2000; 34: 227-8.

  27. Roi GS, Nanni G, Tavana R, et al: Prevalence of anterior cruciate ligament reconstructions in professional soccer players. Sport Sciences for Health 2006; 3(5): 118-21.

  28. Lohmander S, Roos H: Knee ligament injury, surgery and osteoarthrosis. Truth or consequences? Acta Orthop Scand 1994; 65(6): 605-9.

  29. Lohmander S, Östenberg A, Englund M: High prevalence of knee osteoarthritis, pain and functional limitations in female soccer players twelve years after anterior cruciate ligament injury. Arthritis and Rheumatism 2004; 10(50): 3145-52.

  30. Wolf E: Semitendinosis and Gracilis ACL Reconstruction Using the Transfix Technique. Tech in Orthop 1998; 13(4): 329-36.

  31. Harter RA, Osternig LR, Singer KM, et al: Long-term evaluation of knee stability and function following surgical reconstruction for anterior cruciate ligament insufficiency. Am J Sports Med 1988; 16: 434-43.

  32. Zhang LQ, Nuber GW, Bowen MK, et al: Multiaxis muscle strength in ACL deficient and reconstructed knees: compensatory mechanism. Med Sci Sports Exerc 2002; 34: 2-8.

  33. Pinczewski LA, Corry IS, Clingeleffer AJ, et al: A comparison of endoscopic anterior cruciate ligament reconstruction utilizing patellar tendon autografis and hamstring tendon autografis at 2 years. Presented at the Arthroscopy Association of North America, Specialty Day at the AAOS; New Orleans, LA; March 22, 1998.

  34. Yasuda K, Tsujino J, Ohkoshi Y, at al: Graft site morbidity with autogenous semitendinosis and gracilis tendons. Am J Sports Med 1995; 23: 706-14.

  35. Sachs RA, Daniel DM, Stone ML et al: Patello femoral problems after anterior cruciate ligament reconstruction. Am J Sports Med 1989; (17): 760-5.

  36. Rosenberg TD, Franklin JL, Baldwin GN, et al: Extensor mechanism function after patellar tendon graft harvest for anterior cruciate ligament reconstruction. Am J Sports Med 1992; (20): 519-26.




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