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Early clinical and neuromuscular properties in patients with normal or sub-normal subjective knee function after anterior cruciate ligament reconstruction

  • Arthroscopy and Sports Medicine
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Purpose

To determine clinical and neuromuscular properties in patients with normal or sub-normal subjective knee function after finalisation of 6 months’ post-operative rehabilitation following anterior cruciate ligament reconstruction (ACLR).

Methods

Sixty patients after primary anatomical single-bundle hamstring ACLR were prospectively enrolled. Demographics, subjective, clinical and functional status of the injured knee were recorded at baseline, 6 and 12 months post-operatively. Return to pre-injury activities time (months) was monitored. Tensiomyography and isokinetic dynamometry of thigh muscles were performed at 6 months, when standard ACLR rehabilitation is finalized. Based on their IKDC Subjective Knee Evaluation scores at 6 months, they were assigned into “Normal” or “Sub-normal” group. All the above measured parameters were then compared between the two groups.

Results

At 6 months’ timeline, 21 patients (35%) perceived their knee function as “Normal”, while 39 (65%) were “Sub-normal”. There were no differences in clinical status between both groups, but patients in Normal group achieved higher IKDC, Lysholm, Tegner scores as well as higher single-leg hop test. They were taller, had lower body mass index and more of them achieved their preinjury level of activity at 12 months (67% vs. 33%). Tensiomyography revealed higher biceps femoris as well as semitendinosus and semimembranosus radial displacement values on the operated leg in Normal group. Isokinetic dynamometry showed significantly higher normalised peak torque and average power of knee extensor muscles.

Conclusions

Patients who perceive their knee function as normal at 6 months following ACLR presented with better neuromuscular properties of the thigh muscles. Decreased hamstring stiffness seems to be the key to higher return-to-preinjury activity. Postoperative rehabilitation should be more focused on reducing hamstring stiffness in addition to improving knee extensor muscle strength.

Level of evidence II (prospective cohort study).

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Author information

Authors and Affiliations

  1. Department of Orthopaedics and Sports Injuries, General Hospital Celje, Oblakova 5, 3000, Celje, Slovenia

    Domen Stropnik & Matjaž Sajovic

  2. Department of Physiotherapy, Faculty of Health Sciences, University of Ljubljana, Ljubljana, Slovenia

    Alan Kacin

  3. Health Care Centre, Terme Zrece Health Resort, Zrece, Slovenia

    Simona Pavlič-Založnik

  4. Department of Orthopaedic Surgery, University Medical Centre Ljubljana, Ljubljana, Slovenia

    Matej Drobnič

  5. Chair of Orthopedics, Medical Faculty, University of Ljubljana, Ljubljana, Slovenia

    Matej Drobnič

Authors
  1. Domen Stropnik
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  2. Matjaž Sajovic
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  3. Alan Kacin
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  4. Simona Pavlič-Založnik
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  5. Matej Drobnič
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Correspondence to Domen Stropnik.

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Stropnik, D., Sajovic, M., Kacin, A. et al. Early clinical and neuromuscular properties in patients with normal or sub-normal subjective knee function after anterior cruciate ligament reconstruction. Arch Orthop Trauma Surg 140, 1231–1239 (2020). https://doi.org/10.1007/s00402-020-03436-0

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  • DOI: https://doi.org/10.1007/s00402-020-03436-0

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