INFLUENCE OF THE OPEN KINETIC CHAIN ON THE DISTENSION OF THE TRANSPLANT AFTER ANTERIOR CRUCIATE LIGAMENT SURGERY WITH HAMSTRING GRAFT: SEARCH FOR RISK FACTORS
DOI:
https://doi.org/10.15621/ijphy/2020/v7i6/841Keywords:
Anterior cruciate ligament, open kinetic chain, isokinetics, laxity, hamstring graft, GNRBAbstract
Background: Rehabilitation following an anterior cruciate ligament reconstruction (ACLR) will allow the patient to regain his functional capacities and support him in the resumption of sports activity. Rehabilitation also aims to minimize the recurrence risk, ensuring the good development of the patient’s muscular capacities until returning to sport. Isokinetism allows the strengthening and evaluation of this muscular strength of the thigh muscle groups. Still, controversy exists about its use by resistance to knee extension in the open kinetic chain, which would cause the graft's distension. This study aims to determine the influence of muscle strengthening of the quadriceps in the open kinetic chain by using isokinetism on the possible laxity of the anterior cruciate ligament and being able to develop risk factors for it.
Methods: The study is based on a population having benefited from an ACLR with a hamstring graft six months postoperatively. Two groups are differentiated; one group exposed to isokinetic during their rehabilitation, the other group, undergoing rehabilitation without the use of isokinetism is the unexposed group. An anterior knee laxity test is performed six months postoperatively using the unexposed group. According to the same protocol, the anterior knee laxity test is performed 6 months post-operatively using all subjects' GNRB® machine. The test results underwent statistical analysis to determine the relative risk of plastic surgery for each
study group.
Results: Comparing each group's results by a univariate analysis did not reveal any significant results. Multivariate analysis to show interactions between the study groups. It was found that the use of isokinetism would seem not to affect the risk of developing distension for the majority of subjects in the exposed group. A tendency towards protection was found for exposed subjects aged between 25 and 35 regarding the graft's distension. Also, a tendency to protection was found in the exposed subjects regarding an alteration of the graft leading to an anatomically comparable difference.
Conclusion: The use of isokinetism does not seem to cause distension of the graft in patients operated on ACLR when this method is introduced three months postoperatively.
References
Scheffler SU, Unterhauser FN, Weiler A. Graft remodeling and ligamentization after cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc. sept 2008;16(9):834-42.
Claes S, Verdonk P, Forsyth R, Bellemans J. The “Ligamentization” Process in Anterior Cruciate Ligament Reconstruction: What Happens to the Human Graft? A Systematic Review of the Literature. Am J Sports Med. nov 2011;39(11):2476-83.
Burgi CR, Peters S, Ardern CL, Magill JR, Gomez CD, Sylvain J, et al. Which criteria are used to clear patients to return to sport after primary ACL reconstruction? A scoping review. Br J Sports Med. sept 2019;53(18):1154-61.
Edouard, P., Degache, F. Rééducation: Intérêt de l’isocinétisme. In: Guide d’isocinétisme. Elsevier Masson; 2016.
Cvjetkovic D, Bijeljac S, Palija S, Talic G, Radulovic T, Kosanovic M, et al. Isokinetic Testing in Evaluation Rehabilitation Outcome After ACL Reconstruction. Med Arch. 2015;69(1):21.
Jewiss D, Ostman C, Smart N. Open versus Closed Kinetic Chain Exercises following an Anterior Cruciate Ligament Reconstruction: A Systematic Review and Meta-Analysis. J Sports Med. 2017; (2):1-10.
Fukuda TY, Fingerhut D, Moreira VC, Camarini PMF, Scodeller NF, Duarte A, et al. Open Kinetic Chain Exercises in a Restricted Range of Motion After Anterior Cruciate Ligament Reconstruction: A Randomized Controlled Clinical Trial. Am J Sports Med. avr 2013;41(4):788-94.
Mc Nair, P. Force musculaire et rééducation proprioceptive du genou après ligamentoplastie du croisé antérieur. Kinésithérapie Rev. févr 2009;9(85-86):49.
Robert H, Nouveau S, Gageot S, Gagnière B. A new knee arthrometer, the GNRB®: Experience in ACL complete and partial tears. Orthop Traumatol Surg Res. mai 2009;95(3):171-6.
Christel P. Ligament croisé antérieur et stabilité rotatoire. Rev Chir Orthopédique Réparatrice Appar Mot. déc 2005;91(8):18-22.
Nicholettos A, Barcellona MG, Morrissey MC. The immediate effects of open kinetic chain knee extensor exercise at different loads on knee anterior laxity in the uninjured. The Knee. déc 2013;20(6):500-4.
Liu H, Lu W, Liang D, Geng H, Zhu W, Ouyang K, et al. [Effect of isokinetic training of thigh muscle group on graft remodeling after anterior cruciate ligament reconstruction]. Chin J Reconstr Surg. sept 2019;33(9):1088-94.
Perriman A, Leahy E, Semciw AI. The Effect of Open- Versus Closed-Kinetic-Chain Exercises on Anterior Tibial Laxity, Strength, and Function Following Anterior Cruciate Ligament Reconstruction: A Systematic Review and Meta-analysis. J Orthop Sports Phys Ther. juill 2018;48(7):552-66.
Heijne A, Werner S. Early versus late start of open kinetic chain quadriceps exercises after ACL reconstruction with patellar tendon or hamstring grafts: a prospective randomized outcome study. Knee Surg Sports Traumatol Arthrosc. 2 avr 2007;15(4):402-14.
Perry MC, Morrissey MC, King JB, Morrissey D, Earnshaw P. Effects of closed versus open kinetic chain knee extensor resistance training on knee laxity and leg function in patients during the 8- to 14-week postoperative period after anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc. juill 2005;13(5):357-69.
Morrissey MC, Perry MC, King JB. Is Knee Laxity Change After ACL Injury and Surgery Related to Open Kinetic Chain Knee Extensor Training Load?: Am J Phys Med Rehabil. mai 2009;88(5):369-75.
Bieler T, Aue Sobol N, Andersen LL, Kiel P, Løfholm P, Aagaard P, et al. The Effects of High-Intensity versus Low-Intensity Resistance Training on Leg Extensor Power and Recovery of Knee Function after ACL-Reconstruction. BioMed Res Int. 2014;2014:1-11.
Barcellona MG, Morrissey MC, Milligan P, Clinton M, Amis AA. The effect of knee extensor open kinetic chain resistance training in the ACL-injured knee. Knee Surg Sports Traumatol Arthrosc. nov 2015;23(11):3168-77.
Palmieri-Smith RM, Strickland M, Lepley LK. Hamstring Muscle Activity After Primary Anterior Cruciate Ligament Reconstruction—A Protective Mechanism in Those Who Do Not Sustain a Secondary Injury? A Preliminary Study. Sports Health Multidiscip Approach. juill 2019;11(4):316-23.
Mikkelsen C, Werner S, Eriksson E. Closed kinetic chain alone compared to combined open and closed kinetic chain exercises for quadriceps strengthening after anterior cruciate ligament reconstruction with respect to return to sports: a prospective matched follow-up study. Knee Surg Sports Traumatol Arthrosc. nov 2000;8(6):337-42.
Cristiani R, Forssblad M, Engström B, Edman G, Stålman A. Risk Factors for Abnormal Anteroposterior Knee Laxity After Primary Anterior Cruciate Ligament Reconstruction. Arthrosc J Arthrosc Relat Surg. août 2018;34(8):2478-84.
Janssen RPA, van Melick N, van Mourik JBA, Reijman M, van Rhijn LW. ACL reconstruction with hamstring tendon autograft and accelerated brace-free rehabilitation: a systematic review of clinical outcomes. BMJ Open Sport Exerc Med. avr 2018;4(1):e000301.
Van Grinsven S, van Cingel REH, Holla CJM, van Loon CJM. Evidence-based rehabilitation following anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc. août 2010;18(8):1128-44.
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