Influence Of Muscle Strength Recovery On Knee Function After Anterior Cruciate Ligament Reconstruction Surgery

ObjectivesBy analyzing the relationships between the quadriceps, hamstring muscle strength and hamstring/quadriceps strength ratio (H/Q) and Lysholm, Tegner scores, the influence of muscle strength index on knee function and the influence of the syndrome of spleen deficiency on muscle strength recovery.Methods44patients who underwent arthroscopic ACL reconstruction from third orthopedics of No1. affiliate hospital of Guang Zhou Traditional Chinese Medicine(TCM) from December2011to December2012were investigated retrospectively. According to the exclusion criteria,43cases were included finally. Joint stability was measured by using Kneelax device to imitate Lachman test. Contralateral and ipsilateral quadriceps peak torque, hamstrings peak torque, H/Q were measured by Biodex system at60°/s rate. And Tegner and Lysholm score were completed in the form of questionnaires. Test is divided into three parts.1. According to Lysholm scores by excellent, good, medium and poor, patients were divided into four groups. Quadriceps, hamstring muscle strength and H/Q were compared among groups.2. According to Tegner scores by excellent, good, medium and poor, patients were divided into four groups.Quadriceps, hamstring muscle strength and H/Q were compared among groups.3. According spleen deficiency syndrome diagnostic criteria, patients were divided to groups, quadriceps and hamstring muscle strength were compared between groups.Result①There are36persons in excellent Lysholm score and7person in good. The patients has higher Lysholm score with quadriceps and hamstring muscle strength closer to the contralateral muscles (p<0.05).The patients has higher Lysholm score with H/Q in the range of60%-80%(p<0.05).②There are38persons in good Tegner score and5person in medium. The patients has higher Tegner score with quadriceps muscle strength closer to the contralateral muscles (p<0.05). There was no significantly difference on hamstring muscle strength and H/Q between two groups.③There are14persons with the syndrome of spleen deficiency and29without it. Compared with patients without the syndrome of spleen deficiency, recovery of quadriceps strength is more slowly with the syndrome of spleen deficiency(p<0.05).ConclusionQuadriceps and hamstring strength is still lower than the contralateral strength through a one-year rehabilitation after anterior cruciate ligament reconstruction surgery. The recovery of quadriceps and hamstring strength will affect knee functions. Both the level of daily function and exercise capacity of knee will be poorer, whose quadriceps strength recover more slowly. The patients daily function of knee was affected, whose hamstring strength recover more slowly. But exercise capacity of these patients was not affected obviously. The asynchronous recovery of quadriceps and hamstring strength results that the coordination of antagonistic muscles decreases. The range of H/Q from60%to80%is more appropriate. Daily knee function of patients is better, whose H/Q is in the range. Exercise capacity would not be affected with decrease of coordination of antagonistic muscles in short-term. The quadriceps strength of the patients with the syndrome of spleen deficiency would recover more slowly.