STRENGTH CHARACTERISTICS OF KNEE EXTENSORS AFTER ARTHROSCOPY
Helena Gapeyeva, Juan Ereline, Mati Paasuke (University of Tartu, Tartu, Estonia)
The function of the knee joint is closely linked to the integrity of the joint structures, ligaments and the coordinated action of surrounding muscles. Even isolated lesions of ligaments, joint surfaces or menisci can lead to loss of strength that may be associated with muscle atrophy and the presence of abnormalities in the muscle activation. In this work were studied the isometric and isokinetic strength characteristics of knee extensors in a group of eleven patients (six men and three women) aged 17-35 yrs with acute knee ligament or menisci injuries before and one month after the knee arthroscopic surgery.
A computerized electromechanical dynamometric chair was used to measure bilateral isometric maximal voluntary contraction (MVC) of the knee extensor muscles. The subjects were seated with the knee and hip angles equal to 110°. After that the subjects performed bilateral concentric contraction of knee extensors at angular velocities 1.53, 3.06 and 4.59 rad/s using modernized Cybex dynamometer. Peak torque (PT) gravity-corrected values at different velocities was recorded.
One month after the operation the voluntary strength characteristics (MVC) of the operated leg were not recovered to the non-operated leg's level (522.3±55.1 and 715.2±49.7 N resp. in men; 354.0±38.4 and 478.0±32.7 N resp. in women, p<0.05). One month following arthroscopy was founded the increase of PT in operated leg about 8-10 % at angular velocity 1.53 rad/s (p<0.05). At other velocities no significant differences of PT between pre- and post-operative level were established. It can be concluded that one month after surgery strength characteristics of knee extensors still remained lower than in healthy extremity.
RESULTS OBTAINED WITH CLOSED KINETIC CHAIN REHABILITATION PROTOCOLS FOLLOWING ANTERIOR CRHCIATE LIGAHENT RECONSTRUCTION
T. A. KALYON, T. AYDIN, H. YAGMUR, U. GENC
Giilhane Medical Academy, Ankara, Turkey.
40 patients (39 male, 1 female) ranging in age between 19 and 31 (mean: 23.2±3.9) who underwent Anterior Cruciate Ligament (ACL) reconstruction were studied and rehabilitated in accordance with the Closed Kinetic Chain (CKC) protocol. In all cases a comprehensive rehabilitation programme was applied. Results of this programme were evaluated in terms of both clinical-radiological and physical activity levels. Clinical improvement rate was 83 %, while improvement in Timoty criteria was 82 %. Tegner activity level was found to be 5.76 after the completion of the programme. 18 out of 25 active sportsmen had managed to resume their preoperative sports activities.
We conclude that C K C rehabilitation protocols are effective and satisfactory for A C L reconstruction patients undepending on the grafting material.