Réentraînement à l'effort entre le quatrième et le sixième mois après ligamentoplastie de genou au DIDT : comparaison de la pratique de la bicyclette et de la pratique du footing avec un groupe témoin non réentraîné

Abstract

Objective To study the effect of cycling or running retraining between 4 and 6 months after patients underwent anterior cruciate ligament reconstruction with hamstring grafting (Semitendinosus-Gracilis) compared with that in patients who had the same surgery but were untrained. Method Patients who had undergone surgery for an anterior cruciate ligament reconstruction by the same surgeon who used hamstring grafting were included if they were free of knee pain 4 months after the surgery. After giving consent, patients were randomized to receive controlled retraining (cycling or running 3 times a week) or not. The effect of retraining was measured by the evolution of the knee isokinetic peak torque at 60°/s and 180°/s 6 months after surgery. Results Fifteen patients were retrained with cycling (GI), 17 with running (GII) and 15 patients did not retrain (GIII). Before retraining, the 3 groups had the same peak torque deficit, measured at an angular speed of 60°/s and 180°/s, for knee extensors (GI: 33 ± 11% and 27 ± 8%; GII: 30 ± 13% and 24 ± 10%; GIII: 31 ± 15% and 24 ± 13%, respectively) and knee flexors (GI: 26 ± 11% and 20 ± 13%; GII: 20 ± 14% and 17 ± 13%; GIII: 19 ± 15% and 14 ± 15%, respectively). After retraining, progress measured at 60°/s of knee extensors and flexors on the operated knees was 18 ± 9% and 16 ± 10% for GI, 16 ± 9% and 11 ± 11% for GII and 12 ± 15% and 8 ± 12 for GIII, respectively. Progress measured at 180°/s followed the same evolution. After comparison of the 3 groups, any significant difference was put in relief according to the type of retraining. Conclusion Retraining after anterior cruciate ligament reconstruction is necessary for patients to practice their previous sport. In our study, aerobic cycling or running between 4 and 6 months after surgery did not improve peak torque in the operated knee extensors and flexors. However, these 2 types of retraining are well-tolerated.