title: Arthroscopically assisted combined anterior and posterior cruciate ligament reconstruction with autologous hamstring grafts-isokinetic assessment with control group.
abstract: OBJECTIVE
  The aim of the study was to: 1) evaluate the differences in pre-post operative knee functioning, mechanical stability, isokinetic knee muscle strength in simultaneous arthroscopic patients after having undergone an anterior cruciate ligament (ACL) and the posterior cruciate ligament (PCL) with hamstring tendons reconstruction, 2) compare the results of ACL/PCL patients with the control group.
  
  
  METHODS
  Controlled Laboratory Study.
  
  
  METHODS
  Results of 11 ACL/PCL patients had been matched with 22 uninjured control participants (CP). Prior to surgery, and minimum 2 years after it, functional assessment (Lysholm and IKDC 2000), mechanical knee joint stability evaluation (Lachman and "drawer" test) and isokinetic tests (bilateral knee muscle examination) had been performed. Different rehabilitation exercises had been used: isometric, passive exercises, exercises increasing the range of motion and proprioception, strength exercises and specific functional exercises.
  
  
  RESULTS
  After arthroscopy no significant differences had been found between the injured and uninjured leg in all isokinetic parameters in ACL/PCL patients. However, ACL/PCL patients had still shown significantly lower values of strength in relative isokinetic knee flexors (p = 0.0065) and extensors (p = 0.0171) compared to the CP. There were no differences between groups regarding absolute isokinetic strength and flexors/extensors ratio. There was statistically significant progress in IKDC 2000 (p = 0.0044) and Lysholm (p = 0.0044) scales prior to (44 and 60 points respectively) and after the reconstruction (61 for IKDC 2000 and 94 points for Lysholm).
  
  
  CONCLUSIONS
  Although harvesting tendons of semitendinosus and/or gracilis from the healthy extremity diminishes muscle strength of knee flexors in comparison to the CP, flexor strength had improved. Statistically significant improvement of the knee extensor function may indicate that the recreation of joint mechanical stability is required for restoring normal muscle strength. Without restoring normal muscle function and strength, surgical intervention alone may not be sufficient enough to ensure expected improvement of the articular function.
authors.affiliation: Orthopaedic Department, Rehasport Clinic, Poznan, Poland ; Department of Pediatric Orthopaedics and Traumatology, Karol Marcinkowski University of Medical Sciences, Poznan, Poland.
authors.forename: Tomasz
authors.initials: T
authors.lastname: Piontek
authors.affiliation: Orthopaedic Department, Rehasport Clinic, Poznan, Poland ; Department of Pediatric Orthopaedics and Traumatology, Karol Marcinkowski University of Medical Sciences, Poznan, Poland.
authors.forename: Kinga
authors.initials: K
authors.lastname: Ciemniewska-Gorzela
authors.affiliation: Department of Pediatric Orthopaedics and Traumatology, Karol Marcinkowski University of Medical Sciences, Poznan, Poland.
authors.forename: Andrzej
authors.initials: A
authors.lastname: Szulc
authors.affiliation: Orthopaedic Department, Rehasport Clinic, Poznan, Poland.
authors.forename: Jakub
authors.initials: J
authors.lastname: Naczk
authors.affiliation: Orthopaedic Department, Rehasport Clinic, Poznan, Poland.
authors.forename: Martyna
authors.initials: M
authors.lastname: Wardak
authors.affiliation: Department of Traumatology of the Chair of Sports Medicine, University School of Physical Education in Poznan, Poland.
authors.forename: Tadeusz
authors.initials: T
authors.lastname: Trzaska
authors.affiliation: Orthopaedic Department, Rehasport Clinic, Poznan, Poland.
authors.forename: Witold
authors.initials: W
authors.lastname: Dudzinski
authors.affiliation: Research and Development Department, Rehasport Clinic, Poznan, Poland.
authors.forename: Monika
authors.initials: M
authors.lastname: Grygorowicz
mesh_terms: D016118:Anterior Cruciate Ligament / Q000601:surgery*; D001182:Arthroscopy; D001696:Biomechanical Phenomena; D005260:Female; D006801:Humans; D007718:Knee Injuries / Q000601:surgery; D007719:Knee Joint / Q000502:physiology* / Q000601:surgery; D008297:Male; D016119:Posterior Cruciate Ligament / Q000601:surgery*; D019651:Plastic Surgery Procedures; D013710:Tendons / Q000637:transplantation; D014182:Transplantation, Autologous