Isokinetic quadriceps symmetry helps in the decision to return to running after anterior cruciate ligament reconstruction.
Anterior cruciate ligament reconstruction
Isokinetic
Limb symmetry index
Prediction
Quadriceps
Running
Journal
Annals of physical and rehabilitation medicine
ISSN: 1877-0665
Titre abrégé: Ann Phys Rehabil Med
Pays: Netherlands
ID NLM: 101502773
Informations de publication
Date de publication:
Jun 2022
Jun 2022
Historique:
received:
14
12
2020
revised:
05
02
2021
accepted:
14
04
2021
pubmed:
7
6
2021
medline:
10
8
2022
entrez:
6
6
2021
Statut:
ppublish
Résumé
After anterior cruciate ligament reconstruction (ACLR), the decision to allow a return to running is empirical, and the post-operative delay is the most-used criterion. The Quadriceps isokinetic-strength Limb Symmetry Index (Quadriceps LSI), with a cutoff of 60%, could be a useful criterion. To determine the association between a Quadriceps LSI≥60% and return to running after ACLR. Over a 10-year period, we retrospectively included 470 patients who underwent ACLR. Four months after ACLR, participants performed an isokinetic test; quadriceps concentric peak torque was used to calculate the Quadriceps LSI at 60̊/s. With a Quadriceps LSI≥60%, a return to running was suggested. At 6 months after ACLR, participants were clinically evaluated for a return to sport and post-operative middle-term complications. A multivariable predictive model was built to assess the efficiency diagnosis of this cutoff in order to consider cofounding factors. Quadriceps LSI cutoff≥60% was assessed with sensitivity, specificity and the area under the receiver operating characteristic curve (AUC). According to our decision-making process with the 60% Quadriceps LSI cutoff at 60̊/s, 285 patients were authorized to return to running at 4 months after ACLR and 185 were not, but 21% (n=59) and 24% (n=45), respectively, were not compliant with the recommendation. No iterative autograft rupture or meniscus pathology occurred at 6 months of follow-up. On multivariable logistic regression analysis, a return to running by using the 60% Quadriceps LSI cutoff was associated with undergoing the hamstring strand procedure (odds ratio 2.60, 95% confidence interval [CI] 1.75-3.84; P<0.0001) and the absence of knee complications (1.18, 1.07-1.29; P=0.001) at 4 months. The sensitivity and specificity of the 60% Quadriceps LSI cutoff were 83% and 70%, respectively. The AUC was 0.840 (95% CI 0.803-0.877). Using the 60% cutoff of the isokinetic Quadriceps LSI at 4 months after ACLR could help in the decision to allow a return to running.
Sections du résumé
BACKGROUND
BACKGROUND
After anterior cruciate ligament reconstruction (ACLR), the decision to allow a return to running is empirical, and the post-operative delay is the most-used criterion. The Quadriceps isokinetic-strength Limb Symmetry Index (Quadriceps LSI), with a cutoff of 60%, could be a useful criterion.
OBJECTIVE
OBJECTIVE
To determine the association between a Quadriceps LSI≥60% and return to running after ACLR.
METHODS
METHODS
Over a 10-year period, we retrospectively included 470 patients who underwent ACLR. Four months after ACLR, participants performed an isokinetic test; quadriceps concentric peak torque was used to calculate the Quadriceps LSI at 60̊/s. With a Quadriceps LSI≥60%, a return to running was suggested. At 6 months after ACLR, participants were clinically evaluated for a return to sport and post-operative middle-term complications. A multivariable predictive model was built to assess the efficiency diagnosis of this cutoff in order to consider cofounding factors. Quadriceps LSI cutoff≥60% was assessed with sensitivity, specificity and the area under the receiver operating characteristic curve (AUC).
RESULTS
RESULTS
According to our decision-making process with the 60% Quadriceps LSI cutoff at 60̊/s, 285 patients were authorized to return to running at 4 months after ACLR and 185 were not, but 21% (n=59) and 24% (n=45), respectively, were not compliant with the recommendation. No iterative autograft rupture or meniscus pathology occurred at 6 months of follow-up. On multivariable logistic regression analysis, a return to running by using the 60% Quadriceps LSI cutoff was associated with undergoing the hamstring strand procedure (odds ratio 2.60, 95% confidence interval [CI] 1.75-3.84; P<0.0001) and the absence of knee complications (1.18, 1.07-1.29; P=0.001) at 4 months. The sensitivity and specificity of the 60% Quadriceps LSI cutoff were 83% and 70%, respectively. The AUC was 0.840 (95% CI 0.803-0.877).
CONCLUSIONS
CONCLUSIONS
Using the 60% cutoff of the isokinetic Quadriceps LSI at 4 months after ACLR could help in the decision to allow a return to running.
Identifiants
pubmed: 34091057
pii: S1877-0657(21)00061-0
doi: 10.1016/j.rehab.2021.101543
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
101543Informations de copyright
Copyright © 2021 Elsevier Masson SAS. All rights reserved.