A comparison of short and medium term clinical and isokonetik outcomes of three surgical processes of ACL reconstruction

  • Supper C
  • Diebold A
  • Tamalet B
  • et al.
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Abstract

Introduction.- Three surgical processes of anterior cruciate ligament (ACL) reconstruction are being compared. Two of them are involving a tendinous transplant of the hamstring: semi tendinosus/gracilis (ST-G) and semi tendinosus alone (ST-TLS). The latter is using a Facia Lata strip (MacFL). Our goal is to find differences in the clinical and paraclinical outcomes that could have an influence on the rehabilitation. Material and methods.- Included patients benefited froma clinical and isokinetik evaluation in the service between December 2009 and March 2012. Exclusion criteria: past history ofACLlesion of the controlateral knee (already performed on or not), ACL reconstruction on the same joint for the ST-G and the ST- TLS. They benefited fromrehabilitation in a daytime hospital for 30 to 45 days, three to five times aweek, then through private practices.They have been re-examined one to three times between 3 and 21 months after their surgery. The clinical evolution was based on a subjective evaluation (IKDC score) and a standardized examination. The muscular evaluation was made on an isokinetik dynamometer. Results.- One hundred and eighteen patients were included, and among them 40 ST-G, 40 ST-TLS and 38 MacFL. The first evaluation (at around 5.4 month) shows the IKDC scores were of 71,25% (ST-G), 72,28% (ST-TLS) and 67,7% (MacFL). At low speed, the extensor muscles strength deficits were: 12,86% (ST-G), 16,17% (ST-TLS) and 22,65% (MacFL). The flexor muscles strength deficits were: 6,78% (ST-G), 8,52% (ST-TLS) and 2,1% (MacFL). The third evaluation (at around 14 month) shows the IKDC scores were of 77,25% (ST-G), 87,83% (ST-TLS) and 84% (MacFL). At low speed, the extensor muscles strength deficits were: 12.86% (ST-G), 16.17% (ST-TLS) and 22.65% (MacFL). The flexor muscles strength deficits were 6.78% (ST-G), 8.52% (ST-TLS) and 2.1% (MacFL). Discussion/Conclusion.- These preliminary results do not show evidence of major differences on the IKDC score. The isokinetik results seem to indicate the deficit is superior on the extensor muscles among the MacFL and the flexor muscles among the ST-G graft and the ST-TLS.

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Supper, C., Diebold, A., Tamalet, B., Pequignot, R., & Ghozlane, L. (2012). A comparison of short and medium term clinical and isokonetik outcomes of three surgical processes of ACL reconstruction. Annals of Physical and Rehabilitation Medicine, 55, e81. https://doi.org/10.1016/j.rehab.2012.07.202

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