Knee extension and flexion muscle strength six months following anterior cruciate ligament reconstruction: a comparison of patellar tendon and hamstring graft in footballl players

[A. N. Milutinović]

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Ovo istraživanje je imalo za cilj da uporedi oporavak mišićne snage ekstenzora i fleksora kolena nakon rekonstrukcije prednjeg ukrštenog ligamenta (ACL), u zavisnosti od tipa grafta (patele ili hamstringa) kod vrhunskih fudbalera, koji su bili podvrgnuti uporedivim šestomesečnim programima rehabilitacije. Sedamnaest fudbalera je prošlo rekonstrukciju ACL-a primenom grafta patele ili hamstringa. Mišićna snaga ekstenzora i fleksora kolena merena je tri i šest meseci nakon rekonstrukcije, korišćenjem izokinetičkog dinamometra. Umereno-velike asimetrije u maksimalnoj mišićnoj snazi ekstenzora kolena između nogu u trećem mesecu, kod oba grafta (graft patele: p = 0.002, g = -0.94; graft hamstringa: p = 0.02, g = -0.55), smanjene su na trivijalne u šestom mesecu (graft patele: p = 0.30, g = -0.19; graft hamstringa: p = 0.40, g = -0.16), bez značajne razlike u indeksu simetričnosti između graftova u šestom mesecu (p = 0.62, g = -0.24). Slično, umereno-velike asimetrije u maksimalnoj mišićnoj snazi fleksora kolena između nogu u trećem mesecu, kod oba grafta (graft patele: p = 0.13, g = -0.50; graft hamstringa: p = 0.01, g = -0.97), smanjene su na trivijalno-male u šestom mesecu (graft patele: p = 0.25, g = 0.18; graft hamstringa: p = 0.01, g = -0.47); međutim, bolji indeks simetričnosti bio je evidentan kod grafta patele u poređenju sa graftom hamstringa u šestom mesecu (p = 0.007, g = 1.43, velika). Kondicioni treneri i fizioterapeuti, koji rade na oporavku fudbalera sa rekonstrukcijom ACL-a korišćenjem hamstring grafta, treba da se fokusiraju na vežbe za jačanje zadnje lože, kako bi se obezbedila optimalna obnova mišićne snage za potpuni povratak igri.

This study aimed to compare knee extensor and flexor strength recovery following anterior cruciate ligament (ACL) reconstruction between bone-patellar tendon-bone and hamstrings tendons grafts in international, male football players undergoing comparable 6-month rehabilitation programs. Seventeen football players underwent ACL reconstruction with either an autogenous bone-patellar tendon-bone graft or hamstrings tendons graft. Knee extensor and flexor peak torques were measured at 3 months and 6 months in the injured and contralateral legs following surgery using isokinetic dynamometry. The moderate–large asymmetries in knee extensor peak torque between legs at 3 months across graft types (bonepatellar tendon-bone: p = 0.002, g = -0.94; hamstrings tendons: p = 0.02, g = -0.55) were reduced to trivial asymmetries at 6 months (bone-patellar tendon-bone: p = 0.30, g = -0.19; hamstrings tendons: p = 0.40, g = -0.16), with a non-significant difference in limb symmetry index (LSI) between grafts at 6 months (p = 0.62, g = -0.24). Similarly, moderate–large asymmetries in knee flexor peak torque between legs at 3 months across graft types (bonepatellar tendon-bone: p = 0.13, g = -0.50; hamstrings tendons: p = 0.01, g = -0.97) were reduced to trivial-small asymmetries at 6 months (bone-patellar tendon-bone: p = 0.25, g = 0.18; hamstrings tendons: p = 0.01, g = -0.47); however, a superior LSI was evident with bone-patellar tendon-bone compared to HT grafts at 6 months (p = 0.007, g = 1.43, large). Strength and conditioning professionals working with football players who are rehabilitating from ACL reconstruction after receiving a hamstrings tendons graft should give adequate attention to delivering suitable hamstrings exercises that ensure optimal strength restoration.

fudbal, povreda, rehabilitacija, prekid ligamenta, ACL

612.7-001:615.8(043.3)

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