[Principles and value of isokinetic evaluation in ruptures of the anterior cruciate ligament].
Isokinetic muscular evaluation allows to appreciate the knee joint functional patterns in conditions close to sports activities. Analyzing bilateral symmetry and agonist/antagonist ratios of the lower extremity, this method is a useful index for the objective evaluation of ligament-deficient knees. 106 patients with a chronic ACL deficient knee sustained a presurgery isokinetic evaluation. 94 patients had a post-operative evaluation and 13 a pre and post-surgery evaluation. All patients were simultaneously evaluated by clinical examination and measures of instrumental knee laxity (KT 1000). Results showed that isokinetic performance was not correlated to the objective laxity as measured with the KT 1000 but was correlated to 1) the type of laxity (i.e. associated postero-lateral laxity), 2) the functional level of activity, and 3) the time of disability. Best functional results were obtained in patients whose injured knee hamstring/quadriceps (H/Q) ratio was close to the uninjured knee H/Q ratio. The mean quadriceps deficit was over 15 per cent for 75 per cent of the patients one year after surgery, and for 50 per cent of the patients after two years. The quadriceps deficit was not parallel to the length of the autograft taken from the extensor mechanism. Isokinetic evaluation is a guideline for rehabilitation allowing specific strengthening of the weaker muscular groups.
Fossier
E
E
Service de Chirurgie Orthopédique et Traumatologique, Hôpital Saint-Louis, Paris.
Christel
P
P
Djian
P
P
Darman
Z
Z
Witvoët
J
J
D016118:Anterior Cruciate Ligament / Q000601:surgery; D000070598:Anterior Cruciate Ligament Injuries; D004594:Electrophysiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007593:Joint Instability / Q000209:etiology / Q000503:physiopathology* / Q000534:rehabilitation; D007700:Kinetics; D007719:Knee Joint; D008297:Male; D009133:Muscular Atrophy / Q000209:etiology / Q000503:physiopathology / Q000534:rehabilitation; D011184:Postoperative Period
Principes et intérêt de l'évaluation isocinétique dans les ruptures du ligament croisé antérieur.