Difference of Knee Strength Recovery Between Revision and Primary ACL
                    Reconstruction

Marc Dauty; Philippe Combes; Marie Gernigon; Pierre Menu; Vincent Crenn; Pauline Daley; Alban Fouasson-Chailloux

doi:10.1055/a-2253-0103

International Journal of Sports Medicine, Table of Contents

Int J Sports Med 2024; 45(05): 390-398
DOI: 10.1055/a-2253-0103

Orthopedics & Biomechanics

Difference of Knee Strength Recovery Between Revision and Primary ACL Reconstruction

Marc Dauty

¹Service de Médecine Physique et Réadapatation Locomotrice et Respiratoire, CHU Nantes, Nantes, France

²Service de Médecine du Sport, CHU Nantes, Nantes, France

³Institut Régional de Médecine du Sport, CHU Nantes, Nantes, France

,

Philippe Combes

¹Service de Médecine Physique et Réadapatation Locomotrice et Respiratoire, CHU Nantes, Nantes, France

,

Marie Gernigon

⁴CIAMS, Université Paris-Saclay, Gif-sur-Yvette, France

⁵CIAMS, Université d'Orléans, Orleans, France

,

Pierre Menu

¹Service de Médecine Physique et Réadapatation Locomotrice et Respiratoire, CHU Nantes, Nantes, France

²Service de Médecine du Sport, CHU Nantes, Nantes, France

,

Vincent Crenn

⁶Clinique Chirurgicale Orthopédique et Traumatologique, CHU Nantes, Nantes, France

,

Pauline Daley

¹Service de Médecine Physique et Réadapatation Locomotrice et Respiratoire, CHU Nantes, Nantes, France

²Service de Médecine du Sport, CHU Nantes, Nantes, France

,

Alban Fouasson-Chailloux

¹Service de Médecine Physique et Réadapatation Locomotrice et Respiratoire, CHU Nantes, Nantes, France

²Service de Médecine du Sport, CHU Nantes, Nantes, France

³Institut Régional de Médecine du Sport, CHU Nantes, Nantes, France

⁷Inserm, UMR 1229, RMeS, Regenerative Medicine and Skeleton, Université de Nantes, Nantes, France

› Author Affiliations

Abstract

Different grafting procedures are available to restore knee stability after revision anterior cruciate ligament (ACL) reconstruction. We compared knee strength recovery between ACL revision surgery and primary reconstruction. One hundred and ten patients with ACL revision surgery were matched with 110 patients with primary reconstruction based on the graft procedure. The isokinetic knee strength had been assessed for the first 9 months post-surgery. Knee laxity, function, and activity score were also evaluated. Limb symmetry index for knee extensor and flexor strength was not different at 4-, 6- and 9-months post-surgery between revision surgery and primary reconstruction. These results depended on ipsilateral or contralateral graft choice. Ipsilateral hamstring tendon (HT) and contralateral bone-patellar-tendon-bone (BPTB) graft procedures were similar for a revision of a BPTB graft failure. Contralateral HT procedure was better than ipsilateral BPTB procedure for a revision of a HT graft failure. The early recovery of isokinetic knee strength after ACL revision surgery regardless of the HT or BPTB procedures, was similar to the recovery after primary ACL reconstruction with the same graft technique. These results apparently depended on a temporary quadriceps arthrogenic muscle inhibition and on a persistent donor site morbidity, concerning the new and the previous grafts, respectively.

Keywords

revision ACL reconstruction - strength - arthrogenic muscle inhibition - donor site morbidity - return to activity

Full Text

References

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