Isokinetic and anterior cruciate ligament reconstruction with hamstrings or patella tendon graft: analysis of literature.
We report isokinetic results of anterior cruciate ligament reconstruction with patellar tendon or hamstring graft from the literature analysis. The literature was defined from two search "textwords": Isokinetic and Anterior cruciate ligament reconstruction, and from three databases: Medline, Pascal, and Herasmus. Two independent physicians (Physical Medicine and Rehabilitation) carried out an analysis according to the French National Accreditation and Health Evaluation Agency recommendations. Fifty-three studies were selected: 29 reported isokinetic results after anterior cruciate ligament reconstruction with patellar tendon graft, 15 reported isokinetic results after anterior cruciate ligament reconstruction with hamstring graft, and 9 studies compared the two surgical procedures. After discussing different bias and in reference to prospective randomised and comparative studies, the anterior cruciate ligament reconstruction with patellar tendon graft involves a knee extensors deficit during several months. The hamstring surgical procedure involves a less important knee extensor deficit (from 6 to 19 % against 8 to 21 %). Knee sprain and intra-articular surgery involve a long-lasting knee extensors deficit. Anterior cruciate ligament reconstruction with hamstrings graft involves a knee flexors deficit over several months. The patellar tendon surgical procedure involves a less important knee flexors deficit (from 1 to 15 % against 5 to 17 %). In reference to isokinetic parameters, no difference between the two surgical procedures (patellar tendon graft or hamstring graft) is shown after more than twenty-four post-surgical months.
Dauty
M
M
Pôle de Rééducation, Hôpital Saint Jacques, CHU Nantes, Nantes, France. marc.dauty@chu-nantes.fr
Tortellier
L
L
Rochcongar
P
P
D016118:Anterior Cruciate Ligament / Q000601:surgery*; D000070598:Anterior Cruciate Ligament Injuries; D006801:Humans; D007718:Knee Injuries / Q000503:physiopathology / Q000601:surgery*; D007866:Leg; D018482:Muscle, Skeletal / Q000637:transplantation*; D019637:Orthopedic Procedures / Q000379:methods*; D010329:Patella; D019651:Plastic Surgery Procedures / Q000379:methods; D020127:Recovery of Function / Q000502:physiology; D013710:Tendons / Q000637:transplantation*; D016896:Treatment Outcome