Abstract
Little attention has been paid to knee muscle strength after ACL rupture and its effect on prognostic outcomes and treatment decisions. We studied hamstrings (H) and quadriceps (Q) strength correlation with a patient-reported outcome measures score (International Knee Documentation Committee, IKDC), anterior tibial translation (ATT), and time post-injury in 194 anterior cruciate ligament deficient patients (ACLD) who required surgery after a failed rehabilitation program (non-copers). The correlation between knee muscle strength and ATT was also studied in 53 non-injured controls. ACLD patients showed decreased knee muscle strength of both the injured and non-injured limbs. The median (interquartile range) values of the H/Q ratio were 0.61 (0.52–0.81) for patients’ injured side and 0.65 (0.57–0.8) for the non-injured side (p = 0.010). The median H/Q ratio for the controls was 0.52 (0.45–0.66) on both knees (p < 0.001, compared with the non-injured side of patients). The H/Q, ATT, and time post-injury were not significantly correlated with the IKDC score. ATT was significantly correlated with the H/Q of the injured and non-injured knees of patients, but not in the knees of the controls. Quadriceps strength and H/Q ratio were significantly correlated with ATT for both limbs of the patients. IKDC score correlated significantly with the quadriceps and hamstrings strengths of the injured limb but not with the H/Q ratio, ATT or time passed after injury.
Highlights
Non-operative treatment of anterior cruciate ligament (ACL) rupture is a better option over surgical reconstruction for many surgeons
After an adequate neuromuscular and strength-training program, a significant percentage of patients initially classified as non-copers can become copers, avoid anterior cruciate ligament reconstruction (ACLR), and successfully perform sport activities [3]
Knowing if there is a significant correlation between knee strength and these parameters in a population of ACL deficient patients who chose to be operated on after failing conservative treatment would help implement changes in the rehabilitation program to improve the results of the non-operative treatment
Summary
Non-operative treatment of anterior cruciate ligament (ACL) rupture is a better option over surgical reconstruction for many surgeons. After an adequate neuromuscular and strength-training program, a significant percentage of patients initially classified as non-copers can become copers, avoid anterior cruciate ligament reconstruction (ACLR), and successfully perform sport activities [3]. These authors observed that persistent noncopers fared poorly after 2 years and advised a more intensive preoperative rehabilitation. Knowing if there is a significant correlation between knee strength and these parameters in a population of ACL deficient patients who chose to be operated on after failing conservative treatment (non-copers) would help implement changes in the rehabilitation program to improve the results of the non-operative treatment. The second hypothesis was that IKDC does not significantly correlate with ATT and time passed after injury
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