Abstract
Comparing to primary surgery, revision ACL reconstruction is more technically demanding and has a higher failure rate. Theoretically, rehabilitation can improve knee function after ACL reconstruction surgery. This study aimed to compare knee stability, strength, and function between primary and revision ACL reconstructed knees. 40 primary and 40 revision ACL reconstruction surgeries were included between April 2013 and May 2016. Patients with revision surgery had a higher anteroposterior translation comparing those with primary reconstruction (median laxity, 2.0 mm vs. 3.0 mm, p = 0.0022). No differences were noted in knee extensor at 60°/sec or 180°/sec (p = 0.308, p = 0.931, respectively) or in flexor muscle strength at 60°/sec or 180°/sec between primary and revision ACL reconstruction knees (p = 0.091, p = 0.343, respectively). There were also no significant differences between functional scores including IKDC score and Lysholm score in primary versus revision surgeries at 12th months after index operation (p = 0.154, p = 0.324, respectively). In conclusion, despite having higher anteroposterior instability, patients with revision ACL reconstruction can have non-inferior outcomes in isokinetic knee strength and function compared to those with primary ACL reconstruction after proper rehabilitation.
Highlights
In addition to regain the joint stability, the goal of ACLR surgery is to recover the function of the knee joint and muscle strength[10]
To evaluate the success of primary ACLR surgery, joint stability, muscle strength and knee function were common outcomes reported in previous studies[1,10,11]
It is unclear that whether the poor clinical outcomes are from knee joint instability or other factors such as muscle strength
Summary
In addition to regain the joint stability, the goal of ACLR surgery is to recover the function of the knee joint and muscle strength[10]. As being critical to dynamic joint stability, the quadriceps muscle weakness eventually leads to decreased knee function, and poor www.nature.com/scientificreports/. The strength of muscle around the knee joint, especially the quadriceps muscle, was the main target of training and keep indicator for monitoring the functional recovery after ACLR surgery[13]. To evaluate the success of primary ACLR surgery, joint stability, muscle strength and knee function were common outcomes reported in previous studies[1,10,11]. We performed this study to assess the stability and functional recovery after primary and revision ACLR surgery under the scheduled rehabilitation program. This study aimed to (1) compare recovery of knee extensor muscle (quadriceps) and flexor muscle (hamstring) strength in primary versus revision ACLR surgery, and (2) compare clinical functional and stability outcomes in primary versus revision ACLR surgery
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