PDF herunterladen
J Knee Surg 2021; 34(08): 906-912
DOI: 10.1055/s-0039-3402031
Original Article

Bilateral Hidden Isokinetic Quadriceps Performance before and after MPFL Reconstruction in Pediatric Patients

Krzysztof Małecki‡   *
1   Clinic of Orthopaedic and Traumatology, Polish Mother's Memorial Hospital Research Institute, Lodz, Poland
,
Kryspin Niedzielski‡   *
1   Clinic of Orthopaedic and Traumatology, Polish Mother's Memorial Hospital Research Institute, Lodz, Poland
,
Paweł Flont
1   Clinic of Orthopaedic and Traumatology, Polish Mother's Memorial Hospital Research Institute, Lodz, Poland
,
Anna Fabis-Strobin
1   Clinic of Orthopaedic and Traumatology, Polish Mother's Memorial Hospital Research Institute, Lodz, Poland
,
Jarosław Fabis
2   Department of Arthroscopy, Minimally Invasive Surgery and Sports Traumatology, Medical University of Lodz, Lodz, Poland
› Institutsangaben
› Weitere Informationen
    Lizenzen und Reprints

Abstract

We perform prospective study to evaluate the isokinetic performance of quadriceps before and 1 year after medial patella-femoral ligament (MPFL) reconstruction with the adductor magnus tendon in the case of recurrent patellar dislocation. The present study is the first to describe the isokinetic function of the quadriceps of the involved and uninvolved extremity, in such a wide range. The MPFL is a crucial passive stabilizer of patella and, along with the conditions of the anatomical shape of the femoral-patellar joint and the function of quadriceps, influences the overall patellar stability. However, only a few studies have examined indirectly or directly the function of quadriceps. A total of 27 patients (average age at surgery was 15.8 years) with recurrent monolateral patellar dislocation were treated with MPFL reconstruction using the adductor magnus tendon. In the study group, healthy and operated quadriceps were evaluated for the following parameters at the velocities of 60 and 180 deg/s before surgery and in the follow-up examination: peak torque, peak torque to body weight, time to peak torque, peak torque angle, torque in 30 degree of the knee flexion (TQ 30 degree), and the torque in the first 180 milliseconds (TQ 180). Preoperative patellar instability and its normalization after MPFL reconstruction have no impact on the isokinetic quadriceps index value which depends on the time and degree of inactivity as well as implementation of appropriate physiotherapy. The increase in the quadriceps muscle strength of a healthy limb is responsible for the persistence of muscle isokinetic imbalance after MPFL reconstruction in pediatric patients. This is a level 2b study.

Keywords

children - patellar dislocation - isokinetic evaluation - quadriceps

Note

The study was approved by Polish Mother's Memorial Hospital Review Board (approval issue date: October 23, 2010).


* These authors contributed equally to the article.




Publikationsverlauf

Eingereicht: 23. Januar 2019

Angenommen: 10. November 2019

Artikel online veröffentlicht:
06. Januar 2020

© 2020. Thieme. All rights reserved.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 

  • References

  • 1 Avikainen VJ, Nikku RK, Seppänen-Lehmonen TK. Adductor magnus tenodesis for patellar dislocation. Technique and preliminary results. Clin Orthop Relat Res 1993; (297) 12-16
    PubMedSuche in Google Scholar
  • 2 Becher C, Kley K, Lobenhoffer P, Ezechieli M, Smith T, Ostermeier S. Dynamic versus static reconstruction of the medial patellofemoral ligament for recurrent lateral patellar dislocation. Knee Surg Sports Traumatol Arthrosc 2014; 22 (10) 2452-2457
    CrossrefPubMedSuche in Google Scholar
  • 3 Deie M, Ochi M, Sumen Y, Adachi N, Kobayashi K, Yasumoto M. A long-term follow-up study after medial patellofemoral ligament reconstruction using the transferred semitendinosus tendon for patellar dislocation. Knee Surg Sports Traumatol Arthrosc 2005; 13 (07) 522-528
    CrossrefPubMedSuche in Google Scholar
  • 4 Deie M, Ochi M, Sumen Y, Yasumoto M, Kobayashi K, Kimura H. Reconstruction of the medial patellofemoral ligament for the treatment of habitual or recurrent dislocation of the patella in children. J Bone Joint Surg Br 2003; 85 (06) 887-890
    CrossrefPubMedSuche in Google Scholar
  • 5 Malecki K, Fabis J, Flont P, Lipczyk Z, Niedzielski K. Preliminary results of two surgical techniques in the treatment of recurrent patellar dislocation : Medial patellofemoral ligament reconstruction versus combined technique of vastus medialis advancement, capsular plasty and Roux-Goldthwait procedure in treatment of recurrent patellar dislocation. Int Orthop 2016; 40 (09) 1869-1874
    CrossrefPubMedSuche in Google Scholar
  • 6 Malecki K, Fabis J, Flont P, Niedzielski KR. The results of adductor magnus tenodesis in adolescents with recurrent patellar dislocation. Biomed Res Int 2015; 456858
    PubMedSuche in Google Scholar
  • 7 Sillanpää P, Mattila VM, Visuri T, Mäenpää H, Pihlajamäki H. Ligament reconstruction versus distal realignment for patellar dislocation. Clin Orthop Relat Res 2008; 466 (06) 1475-1484
    CrossrefPubMedSuche in Google Scholar
  • 8 Panagiotopoulos E, Strzelczyk P, Herrmann M, Scuderi G. Cadaveric study on static medial patellar stabilizers: the dynamizing role of the vastus medialis obliquus on medial patellofemoral ligament. Knee Surg Sports Traumatol Arthrosc 2006; 14 (01) 7-12
    CrossrefPubMedSuche in Google Scholar
  • 9 Colvin AC, West RV. Patellar instability. J Bone Joint Surg Am 2008; 90 (12) 2751-2762
    CrossrefPubMedSuche in Google Scholar
  • 10 Fithian DC, Paxton EW, Cohen AB. Indications in the treatment of patellar instability. J Knee Surg 2004; 17 (01) 47-56
    Thieme ConnectPubMedSuche in Google Scholar
  • 11 Kreuz PC, Peterson L, van der Werf-Grohmann N, Vohrer M, Schwering L. Clinical and electromyographic results of proximal and distal realignment procedures in young patients with recurrent patellar dislocations. Am J Sports Med 2013; 41 (07) 1621-1628
    CrossrefPubMedSuche in Google Scholar
  • 12 Mäenpää H, Huhtala H, Lehto MU. Recurrence after patellar dislocation. Redislocation in 37/75 patients followed for 6-24 years. Acta Orthop Scand 1997; 68 (05) 424-426
    CrossrefPubMedSuche in Google Scholar
  • 13 Mariani PP, Caruso I. An electromyographic investigation of subluxation of the patella. J Bone Joint Surg Br 1979; 61-B (02) 169-171
    CrossrefPubMedSuche in Google Scholar
  • 14 Wilk KE, Davies GJ, Mangine RE, Malone TR. Patellofemoral disorders: a classification system and clinical guidelines for nonoperative rehabilitation. J Orthop Sports Phys Ther 1998; 28 (05) 307-322
    CrossrefPubMedSuche in Google Scholar
  • 15 Asaeda M, Deie M, Fujita N. et al. Knee biomechanics during walking in recurrent lateral patellar dislocation are normalized by 1 year after medial patellofemoral ligament reconstruction. Knee Surg Sports Traumatol Arthrosc 2016; 24 (10) 3254-3261
    CrossrefPubMedSuche in Google Scholar
  • 16 Carnesecchi O, Philippot R, Boyer B, Farizon F, Edouard P. Recovery of gait pattern after medial patellofemoral ligament reconstruction for objective patellar instability. Knee Surg Sports Traumatol Arthrosc 2016; 24 (01) 123-128
    CrossrefPubMedSuche in Google Scholar
  • 17 Baksi D, Pal A, Baksi D. Electromyographic investigation of unstable patella before and after its realignment operation. Indian J Orthop 2011; 45 (01) 69-73
    CrossrefPubMedSuche in Google Scholar
  • 18 Mäenpää H, Latvala K, Lehto MU. Isokinetic thigh muscle performance after long-term recovery from patellar dislocation. Knee Surg Sports Traumatol Arthrosc 2000; 8 (02) 109-112
    CrossrefPubMedSuche in Google Scholar
  • 19 Rauschning W, Nordesjö LO, Nordgren B. Isokinetic knee extension strength and pain before and after correction of recurrent patellar dislocation. Arch Orthop Trauma Surg 1983; 102 (02) 102-106
    CrossrefPubMedSuche in Google Scholar
  • 20 Ronga M, Oliva F, Longo UG, Testa V, Capasso G, Maffulli N. Isolated medial patellofemoral ligament reconstruction for recurrent patellar dislocation. Am J Sports Med 2009; 37 (09) 1735-1742
    CrossrefPubMedSuche in Google Scholar
  • 21 Oliva F, Ronga M, Longo UG, Testa V, Capasso G, Maffulli N. The 3-in-1 procedure for recurrent dislocation of the patella in skeletally immature children and adolescents. Am J Sports Med 2009; 37 (09) 1814-1820
    CrossrefPubMedSuche in Google Scholar
  • 22 Jerosch J, Prymka M. Knee joint proprioception in patients with posttraumatic recurrent patella dislocation. Knee Surg Sports Traumatol Arthrosc 1996; 4 (01) 14-18
    CrossrefPubMedSuche in Google Scholar
  • 23 Smith TO, Mann CJ, Donell ST. Does knee joint proprioception alter following medial patellofemoral ligament reconstruction?. Knee 2014; 21 (01) 21-27
    CrossrefPubMedSuche in Google Scholar
  • 24 Sherman SL, Deasis DP, Garrone AJ, Voss EE, Oliver HA. Return to Play after Patellar Stabilization. Curr Rev Musculoskelet Med 2018; 11 (02) 280-284
    CrossrefPubMedSuche in Google Scholar
  • 25 Myer GD, Paterno MV, Ford KR, Quatman CE, Hewett TE. Rehabilitation after anterior cruciate ligament reconstruction: criteria-based progression through the return-to-sport phase. J Orthop Sports Phys Ther 2006; 36 (06) 385-402
    CrossrefPubMedSuche in Google Scholar
  • 26 Sakuraba K. [Isokinetic torque of the knee extensor and flexor in patients with recurrent patellar dislocation]. Nippon Seikeigeka Gakkai Zasshi 1992; 66 (07) 657-667
    PubMedSuche in Google Scholar
  • 27 Salzman A, Torburn L, Perry J. Contribution of rectus femoris and vasti to knee extension. An electromyographic study. Clin Orthop Relat Res 1993; (290) 236-243
    PubMedSuche in Google Scholar
  • 28 Vitale TE, Mooney B, Vitale A, Apergis D, Wirth S, Grossman MG. Physical Therapy intervention for medial patellofemoral ligament reconstruction after repeated lateral patellar subluxation/dislocation. Int J Sports Phys Ther 2016; 11 (03) 423-435
    PubMedSuche in Google Scholar
  • 29 Krych AJ, O'Malley MP, Johnson NR. et al. Functional testing and return to sport following stabilization surgery for recurrent lateral patellar instability in competitive athletes. Knee Surg Sports Traumatol Arthrosc 2018; 26 (03) 711-718
    CrossrefPubMedSuche in Google Scholar
  • 30 Osowska K, Fabiś J, Fabiś A, Grodzka M, Zwierzchowski JT. The evaluation of the influence of selected patellofemoral joint geometry indicators observed in magnetic resonance imaging on the incidence of anterior knee pain in patients after anterior cruciate ligament reconstruction using hamstrings. Pol Orthop Traumatol 2013; 78: 247-250
    PubMedSuche in Google Scholar
  • 31 Halabchi F, Mazaheri R, Seif-Barghi T. Patellofemoral pain syndrome and modifiable intrinsic risk factors; how to assess and address?. Asian J Sports Med 2013; 4 (02) 85-100
    CrossrefPubMedSuche in Google Scholar
  • 32 Davies G. A compendium of isokinetics in clinical usage and rehabilitation techniques. 4th Edition. Onalaska, Wisconsin, USA: S&S Publishers; 1992
    Suche in Google Scholar
  • 33 Fisher B, Nyland J, Brand E, Curtin B. Medial patellofemoral ligament reconstruction for recurrent patellar dislocation: a systematic review including rehabilitation and return-to-sports efficacy. Arthroscopy 2010; 26 (10) 1384-1394
    CrossrefPubMedSuche in Google Scholar
  • 34 De Ste Croix MB, Deighan MA, Ratel S, Armstrong N. Age- and sex-associated differences in isokinetic knee muscle endurance between young children and adults. Appl Physiol Nutr Metab 2009; 34: 725-731
    CrossrefPubMedSuche in Google Scholar