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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.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Extension Deficit (>5 degrees) | Experimental | Patients who had a knee extension ROM deficit of more than 5 degrees in the fourth week will be subject to the rehabilitation program under the supervision of the same physiotherapist 3 days a week for a period of 12 weeks. The rehabilitation program will include cold therapy, electrotherapy, and exercises focusing on improving knee functioning and restoring muscle strength. From 12 weeks to 6 months, a home exercise program will be advised to all patients equally. |
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| Extension Deficit (<5 degrees) | Active Comparator | Patients who had a knee extension ROM deficit of less than 5 degrees in the fourth week will be subject to the rehabilitation program under the supervision of the same physiotherapist 3 days a week for a period of 12 weeks. The rehabilitation program will include cold therapy, electrotherapy, and exercises focusing on improving knee functioning and restoring muscle strength. From 12 weeks to 6 months, a home exercise program will be advised to all patients equally. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Extension Deficit (>5 degrees) | Other | Patients who had a knee extension ROM deficit of more than 5 degrees will included |
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| Measure | Description | Time Frame |
|---|---|---|
| Quadriceps Muscle Strength Recovery | Isometric, concentric and eccentric quadriceps muscle strength will be measured using an isokinetic dynamometer (IsoMed®2000 D&R GmbH, Germany). | Qudriceps muscle strength will be measured at 4th weeks (isometric), 12 th weeks (isometric and concentric), 6th months (isometric, concentric, and eccentric) following a surgery. |
| Hamstring Muscle Strength Recovery | Isometric, concentric and eccentric hamstring muscle strength will be measured using an isokinetic dynamometer (IsoMed®2000 D&R GmbH, Germany). | Hamstring muscle strength will be measured at 4th weeks (isometric), 12 th weeks (isometric and concentric), 6th months (isometric, concentric, and eccentric) following a surgery. |
| Measure | Description | Time Frame |
|---|---|---|
| The Y Balance Test. Functional Testing 1 | The Y Balance Test will be used. Three repetitions will be conducted for each limb, and mean values were recorded in centimeters. | Assessments will be conducted at 12th weeks and 6th months following a surgery |
| The Vertical Jump Test. Functional Testing 2 |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Leyla Eraslan, Ph. D. | Contact | +905348488373 | leylaseraslan@gmail.com |
| Name | Affiliation | Role |
|---|---|---|
| Leyla Eraslan, Ph. D. | Hacettepe University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Hacettepe University, Faculty of Physical Therapy and Rehabilitation | Recruiting | Ankara | 06100 | Turkey (Türkiye) |
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| ID | Term |
|---|---|
| D000070598 | Anterior Cruciate Ligament Injuries |
| ID | Term |
|---|---|
| D007718 | Knee Injuries |
| D007869 | Leg Injuries |
| D014947 | Wounds and Injuries |
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| Extension Deficit (<5 degrees) | Other | Patients who had a knee extension ROM deficit of less than 5 degrees will included |
|
The Vertical Jump Test will be used. Three repetitions will be conducted for each limb, and mean values were recorded in centimeters. |
| Assessments will be conducted at 12th weeks and 6th months following a surgery |
| The Single Leg Hop Test. Functional Testing 3 | The Single Leg Hop Test will be used. Three repetitions will be conducted for each limb, and mean values were recorded in centimeters | Assessments will be conducted at 12th weeks and 6th months following a surgery |
| The Lysholm score. Patient-reported outcomes measures 1 | The Lysholm score will be used to assess self-reported recovery. The Lysholm score is an eight-item questionnaire that evaluates patients following knee ligament injury. This is scored on a 100-point scale from 0 (worst symptoms) to 100 (best symptoms), with 25 points attributed to pain, 15 to locking, 10 to swelling, 25 to instability,10 to stair climbing and 5 points each to limping, use of a support and squatting. | Self-reported recovery will be recorded at 12th weeks and 6th months following a surgery |
| The International Knee Documentation Committee subjective knee form (IKDC). Patient-reported outcomes measures 2 | The International Knee Documentation Committee subjective knee form (IKDC) will be used to assess self-reported recovery. IKDC subjective knee form contains 18 selected items designed to measure symptoms. Total IKDC score ranges from 0 to 100, with 100 indicating the absence of symptoms and higher levels of knee function. | Self-reported recovery will be recorded at 12th weeks and 6th months following a surgery |