Longitudinal effects of anterior cruciate ligament injury and patellar tendon autograft reconstruction on neuromuscular performance.
We examined persons after anterior cruciate ligament injury and for 1.5 years after anterior cruciate ligament reconstruction to analyze changes in anterior knee laxity, lower extremity muscle strength, endurance, and several parameters of neuromuscular function. Sixteen men and nine women (average age, 23.8 years) were evaluated preoperatively, then underwent intraarticular autogenous patellar tendon anterior cruciate ligament reconstruction by the same surgeon and were evaluated at 6, 12, and 18 months postoperatively. Muscle strength was measured isokinetically and neuromuscular function was quantified with simultaneous anterior tibial translation and surface electromyography tests. Forty subjects (26 men and 14 women; average age, 23.5 years) with no known knee abnormalities served as the control group. Subjective questionnaire results showed that by 18 months postoperatively, 20 subjects (80%) believed they had regained their preoperative levels of function. Unfortunately, muscle function in most subjects had not returned to normal. At 12 to 18 months postoperatively, when knee rehabilitation was terminated, significant deficiencies in muscle performance persisted in most patients. Interestingly, in this group of stable knees, quadriceps and hamstring muscle reaction times appeared to be the best objective indicators of subjective knee function.
Wojtys
E M
EM
MedSport, Section of Orthopaedic Surgery, University of Michigan, Ann Arbor 48106, USA.
Huston
L J
LJ
D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D016118:Anterior Cruciate Ligament / Q000601:surgery*; D000070598:Anterior Cruciate Ligament Injuries; D016022:Case-Control Studies; D004576:Electromyography; D016552:Ergometry; D005260:Female; D006801:Humans; D007719:Knee Joint / Q000503:physiopathology / Q000601:surgery; D007866:Leg / Q000502:physiology; D016014:Linear Models; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000502:physiology*; D010329:Patella; D011446:Prospective Studies; D016059:Range of Motion, Articular / Q000502:physiology; D011930:Reaction Time; D013710:Tendons / Q000637:transplantation*; D019415:Torque; D014182:Transplantation, Autologous; D016896:Treatment Outcome