Évaluation fonctionnelle isocinétique et neuromusculaire du genou, retour au sport après reconstruction du ligament croisé antérieur. Étude prospective d’une cohorte de 234 sportifs au recul moyen de 6 mois

Abstract

BackgroundTen percent or less reduction in isokinetic and functional test performance in comparison with the healthy side is generally considered to be a sign of satisfactory functional recovery after reconstruction of the anterior cruciate ligament (ACL). The main objective of this work was to assess postoperative functional recovery of the knee joint in a large cohort. MethodsThis was a single-center prospective cohort recruited from 2012 among patients undergoing ACL repair performed by four surgeons. A retrospective analysis of data included a series of athletes who underwent the procedure in 2013–2016 for primary ACL tear, had a healthy contralateral knee, and had had postoperative functional tests. Isokinetic tests measured flexion and extension strength: concentric quadriceps 60°/s (Q60°) and 240°/s (Q240°); excentric hamstrings 30°/s (HS30°). Four single leg hop tests were performed: single leg hop for distance (SH), triple hop for distance (TH), cross-over hop for distance (CH), and single leg 6m timed-hop (6mH). The main outcome was postoperative functional recovery (yes/no) defined as≤10 % for Q60° and SH. ResultsThe study included 234 patients; mean age 28.4±8.6 years. At 6.5±1.7 (4–12) months, 44 patients (18.5 %) had recovered satisfactory function, 52 (21.8 %) at Q60° and 125 (54.3 %) at SH. During follow-up there were four cases of recurrent tears in the group with unsatisfactory functional recovery. ConclusionSix-months after ACL reconstruction, functional recovery of the knee joint is generally not satisfactory and appears to constitute a risk factor for recurrent tear.