Fuerza muscular de rodilla y resultados auto informados en pacientes con rotura del ligamento cruzado anterior

Abstract

Background: After anterior cruciate ligament (ACL) rupture, changes in knee strength occur that can affect the functionality of the patient. A high percentage of patients require ACL reconstruction to return to the level of function prior to the injury. Knee strength deficits can even get worse time after the rupture. Several studies have compared results between groups operated on with one and two hamstring tendons, publishing controverted findings. Methodology: This work is a doctoral thesis report by compendium of three studies published in international journals with an impact factor in JCR. Patients operated on for unilateral ACL insufficiency were studied, comparing three different situations. The assessment parameters were anterior tibial translation (ATT), bilateral knee flexor and extensor strength, the ratio between these (H/Q), and the IKDC and Lysholm Knee Score self-assessment questionnaires. Results: In the first article, patients operated on with the "all inside" technique were evaluated. Significant differences in ATT and self-reported function were reported between preoperative values and 1 year after surgery, these differences lasting up to 5 years after surgery. In the second paper, ACL-deficient patients showed decreased knee muscle strength in both injured and uninjured extremities. A significant correlation was observed between the ATT with the H/Q ratio, and the IKDC values with the strength of the quadriceps and hamstrings of the injured limb. In the third paper, the knee flexor strength and IKDC values were significantly lower 5 years after reconstruction in patients operated with two hamstring tendons in comparison with patients reconstructed with only one tendon. Conclusions: Between 1 and 5 years after ACL reconstruction with the "all-inside" technique, favorable results are achieved when measured objectively and with patient reported outcomes. After an ACL tear, muscle strength conditioning of both the injured and non-injured extremities should be implemented as soon as possible. Five years after surgery, the use of two hamstring grafts provides worse results in flexor strength and IKDC than the use of a single hamstring graft