| Abstrakt: |
We investigated the effects of the use of different autograft materials on the early postoperative recovery of extensor muscle strength after anterior cruciate ligament (ACL) reconstruction. Reconstruction was performed in 172 athletes with ACL-deficient knees; in 32, a quadriceps tendon-patellar tendon substitute (QTS) was used; in 79, semitendinosus and gracilis tendons (STG) were used; and in 61, a bone-patellar tendon-bone graft (BTB) was used. For QTS and STG autografts, a ligament augmentation device was used. Each group received the same accelerated rehabilitation program. Muscle strength was measured periodically 3–18months after the operation, using a Cybex II dynamometer (Cybex Division of Lumex, Ronkonkoma, NY, USA). Knee extensor strength was evaluated, using the side-to-side ratio and the body weight ratio, to give a precise assessment of permissible sporting activity. After a period of 1year, the percentage of athletes who recovered their extensor muscle strength at a level more than 80% of that in the uninvolved knee was 15.6% for those with QTS grafts, 41.0% for those with BTB grafts, and 77.9% for those with STG grafts (P< 0.001 between QTS and STG, P< 0.05 between QTS and BTB, and P< 0.001 between BTB and STG). The body weight ratio in men showed that, after reconstruction, recovery of extensor muscle strength sufficient for participation in vigorous sport required 6months for STG grafts, 12months for BTB grafts, and 18months for QTS grafts. |
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