Assessment of quadriceps/hamstring strength, knee ligament stability, functional and sports activity levels five years after anterior cruciate ligament reconstruction

Abstract

The purpose of this study was to examine individuals 5 years after ACL reconstruction and analyze changes involving strength, stability, function, and sports activities. Nineteen males and six females, mean age = 31.4 +/- 7.31 years, participated in this study. Fifteen subjects had received extraarticular and ten subjects had received intraarticular ACL reconstructions. Subjects completed a 100 point subjective functional activity questionnaire and a sports participation survey. Knee ligament stability was assessed during an objective knee examination. Isokinetic quadriceps and hamstring muscle strength were tested at 240 and 120 deg/sec using the Cybex II dynamometer. Anterolateral rotatory instability and positive Lachman were elicited on the operated leg for 80% of the subjects. No significant relationship was found between objective instability and the functional activity score. For the intraarticular group, a significant correlation (P less than 0.05) was found between increased quadriceps and hamstring strength on the operated leg and return to functional activities. Subjects' functional activity score was positively correlated (P less than 0.001) with their ability to participate in sports. Subjects participating in sports involving cutting and twisting motions were less successful in returning to their preinjury participation levels and reported more subjective complaints of pain, swelling, and/or instability. These results indicate that long-term progressive rehabilitation emphasizing increased quadriceps and hamstring strength to approximate the nonoperated leg may enhance successful return to functional and sports activities after ACL reconstruction.

Patella Fracture During Rehabilitation After Bone-Patellar Tendon-Bone Anterior Cruciate Ligament Reconstruction: 2 Case Reports

“…3,19,35,48,52, 54,59,70,73 It has also been suggested that pain caused by harvesting the BPTB graft itself prevents the patient from exercising properly after surgery, resulting in persistent quadriceps femoris weakness 52,53,62-65 and consequent functional limitation. 19,35 Patients who engage in quadriceps-strengthening exercises as part of their rehabilitation after ACL reconstruction demonstrate improvements in quadriceps strength and physical function.…”

The relationship between participation restrictions and selected clinical measures following anterior cruciate ligament reconstruction

“…When assessing patients with a history of anterior cruciate ligament reconstruction (ACLR), it is important to determine their level of participation restriction. Specifically this may include the assessment of patient-perceived levels of function during activities of daily living (ADL), work, or sporting activities by patient self-report measures [16,26,27,29,38], such as the Knee Outcome Survey [5,18] and the Cincinnati Knee Scoring System (CKS) [2,25].…”

Assessing activity participation in the ACL injured population: a systematic review of activity rating scale measurement properties

“…Activities and sports have been listed either with a pre-determined rank 7,18,53 or for the subject to provide a numerical quantification of participation frequency or symptom provocation. 19,51 The primary concern with this type of scale is the criteria selected to perform the ranking of activities, where agreement is often lacking. 31 The importance of condition specificity should also be considered in the ranking since there are sports where demands on the knee are extremely high, but ACL injury may have a small effect (e.g.…”

“…Similarly, when considering the impact which activity participation may have on the outcome of an intervention the tool must be capable of both quantifying an individual's level of participation and defining groups for comparative analysis. 17 Authors of the first rating scales 10,11,[18][19][20] should be commended for identifying the importance of assessing participation in the ACL injured population and for developing rating scales. However, by current standards, many were poorly developed and insufficiently investigated before being introduced.…”