Abstract
Patellar tendon graft(PT) and hamstring tendon graft(HS) are commonly available autograft for anterior cruciate ligament reconstruction(ACLR) surgery. Few studies have been reported on the longitudinal comparison of recovery patterns between two autograft types during controlled ambulatory phase which was crucial period for rehabilitation. PURPOSE To investigate different characteristics of isokinetic recovery patterns according to graft types, and to suggest a proper rehabilitation protocol based on the different characteristics especially in controlled ambulatory phase. METHODS Twenty two patients who had received ACLR using either PT (n=12) or HS (n=10) were selected. All of them participated in our accelerated rehabilitation program emphasizing the early restoration of strength and dynamic performance 3 to 12 weeks after surgery. Serial isokinetic muscle performance tests for the knee extension/exion were done with angular velocity of 180°/sec at 6, 8 and 12 weeks. Peak torque, work fatigue ratio and average work (power) were used to assess the recovery patterns in both groups. The differences of serial comparisons were analyzed by general linear model repeated measure. RESULTS Any differences between PT and HS groups were not found in age, sex, duration of injury to surgery, and tests for laxity. Peak torque of knee extension showed similar values in PT (104.3±30.2%) and HS (109.5±36.7 %) 12 weeks after surgery. In knee flexion, PT group (80.99±15.48) attained greater strength than that of HS group (64.01±23.17). However, there was no significant difference in recovery pattern of peak torque of extension/flexion in both groups. In work fatigue ratio, PT group showed faster recovery than HS group from 8 to 12 weeks. PT group revealed the remarkable increase of average work from 6 to 8 weeks, but, HS group showed slower recovery until 12 weeks, especially in knee flexion. This recovery pattern of two groups in average work was significantly different. (P<0.05) CONCLUSIONS Knee extensor/flexor performance of PT group recovered better than HS group during controlled ambulatory phase. HS group showed similar recovery to PT group in knee extensor strength, but not in endurance and power. We suggest that rehabilitation program in this phase should emphasize the endurance and power recovery of knee extensor/flexor rather than strength recovery in ACLR using hamstring graft.
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