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Knee Surgery, Sports Traumatology, Arthroscopy

Published in:

01-08-2015 | Knee

Significantly worse isokinetic hamstring–quadriceps ratio in patellofemoral compared to condylar defects 4 years after autologous chondrocyte implantation

Authors: Sebastian Müller, Anja Hirschmüller, Christoph Erggelet, Nicholas A. Beckmann, Peter C. Kreuz

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 8/2015

Abstract

Purpose

Detailed biomechanical analysis including isokinetic muscle strength measurements after autologous chondrocyte implantation (ACI) are still rare, but might be of crucial importance for long-term outcomes. The present prospective study was performed to evaluate whether defect location had any influence on clinical and biomechanical outcomes 4 years after ACI.

Methods

Forty-four patients with full-thickness cartilage defects ICRS grade III B and C underwent ACI and were assigned to two groups, the femoral condyle group or the patellofemoral joint group. Clinical scores were gathered preoperatively and 6, 12 and 48 months after implantation using the International Knee Documentation Committee (IKDC) score and the International Cartilage Repair Society (ICRS) form. Isokinetic strength measurements were performed 48 months postoperatively comparing healthy and operated knee joint of each patient.

Results

Clinical scores (ICRS, IKDC) showed continuous significant (p < 0.05) improvement over the study period for both groups. Isokinetic muscle strength measurements showed significantly reduced maximum strength capacities for the operated knee joint compared to the healthy knee in both groups (p < 0.05). Hamstring–quadriceps ratios of the operated extremity revealed a significant change in physiological muscle balancing (ratios >1.0) based on significantly impaired extensor muscle strength in the patellofemoral joint group.

Conclusion

All patients showed significant strength deficits on the operated extremity 4 years after ACI. Furthermore, the patellofemoral compartment in particular showed significantly worse hamstring–quadriceps ratios compared to condylar defects. Consequently, more efforts should be made to restore muscular strength especially of the quadriceps and the rehabilitation protocol should be adjusted accordingly.

Level of evidence

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Title: Significantly worse isokinetic hamstring–quadriceps ratio in patellofemoral compared to condylar defects 4 years after autologous chondrocyte implantation
Authors: Sebastian Müller
Anja Hirschmüller
Christoph Erggelet
Nicholas A. Beckmann
Peter C. Kreuz
Publication date: 01-08-2015
Publisher: Springer Berlin Heidelberg
Published in: Knee Surgery, Sports Traumatology, Arthroscopy / Issue 8/2015
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI: https://doi.org/10.1007/s00167-014-2964-y

At a glance: The STEP trials

Springer Medicine

Significantly worse isokinetic hamstring–quadriceps ratio in patellofemoral compared to condylar defects 4 years after autologous chondrocyte implantation

Abstract

Purpose

Methods

Results

Conclusion

Level of evidence

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

Level of evidence

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