Knee Extension Deficit Following an Anterior Cruciate Ligament Reconstruction (Extension Loss)

Investigating the Knee Extension Deficit on Knee Strength Recovery Following an Anterior Cruciate Ligament Reconstruction

Knee extension loss following an anterior cruciate ligament (ACL) reconstruction is believed to play an important role in quadriceps strength recovery. One of the main goals of the rehabilitation following ACL reconstruction is to restore knee extensor muscle strength. Deficits of more than a five-degree extension range of motion (ROM) could lead to delayed knee functionality and anterior knee pain. However, the effect of knee extension deficits in the early postoperative phase of the ACL reconstruction on knee extensor muscle strength recovery and knee functionality is not yet known.

This study aimed to investigate the difference between knee extensor muscle strength recovery and knee functionality in patients with ACL repair who had a knee extension ROM deficit (>5°) in the early postoperative period and those who did not.

Knee range of motion deficits are significant surgical complications following an anterior cruciate ligament (ACL) reconstruction, and despite current advances in surgical techniques, knee range of motion cannot always be regained. Previous studies reported that knee range of motion (ROM) deficits play an important role in knee extensor muscle weakness and knee osteoarthritis. Thus, deficits in knee extension joint motion are more difficult to tolerate than flexion deficits. It has been reported that a five-degree decrease in the extension ROM of the affected knee compared to the healthy side can lead to secondary complications such as difficulty walking and anterior knee pain. However, the effect of knee extension deficits in the early postoperative phase of the ACL reconstruction on knee extensor muscle strength recovery and knee functionality is not yet known.

This study aimed to investigate the difference between knee extensor muscle strength recovery and knee functionality in patients with ACL repair who had a knee extension ROM deficit (>5°) in the early postoperative period and those who did not.

Inclusion Criteria:

• Patients who underwent ACL repair using hamstring tendon autograft
• volunteered to participate in the study between the ages of 18-45
• a non-contact injury mechanism
• a Tegner Activity Score >5 before the injury
• regularly attended the rehabilitation program after surgery (not missing more than three sessions)

Exclusion Criteria:

• Patients who underwent ACL repair with patellar tendon autograft or allograft, revision surgery
• underwent meniscus and or cartilage repair in addition to ACL repair
• a history of previous knee, ankle, or groin injuries
• concomitant systemic and/or neurological pathologies
• a history of injury to the contralateral lower extremity
• do not want to participate in the evaluations that should be done before the study.