Biomechanics of periarticular knee muscles after ACL surgery in young patients – comparison of autograft reconstruction and suture-tape augmented primary repair

• Autorzy: Zalewska Paulina , Góralczyk Adrian , Guszczyn Tomasz , Hermanowicz Krzysztof , Piszczatowski Szczepan

Identyfikatory

DOI

10.37190/ABB-02564-2024-02

• Języki publikacji: EN

Abstrakty

EN

Last years brought a growing interest in suture-tape augmented ACL repair techniques instead of ACL reconstructions with autografts due to their limited success rates. However, there is a lack of experimental studies comparing the infl uence of both procedures on knee periarticular muscles biomechanics. The aim of the study was to analyze periarticular muscles torq ue and their activity during movement for young patients after ACL repair (IB) and ACL reconstruction (ACLR), compare them with each other and with a healthy subjects (Controls). Methods: Isokinetic torques of knee flexors and extensors and their EMG activity during gait and drop vertical jump (DVJ) were measured in 48 patients (IB – 20, ACLR – 28) at least one year after surgery and in 25 healthy controls. Results: The muscle torques in the operated limb were lower in both group of patients comparing to Controls, but IB scored the lowest values (79% of Controls for extensors, p = 0.005; 74% for flexors, p = 0.001). Decrease of muscle torques in the contralateral limb occurred only in IB group (84% of Controls for both extensors ( p = 0.045) and flexors). Increased hamstrings activity were noticed for ACLR comparing to IB and Controls. The balance between activity of muscles actin g on the medial and lateral side of the knee for ACLR tilts more towards the lateral side. Conclusions: Increased hamstrings activity and changes in balance between laterally and medially located muscles indicate on the increased need for muscle support of kn ee stability in ACLR patients.

Słowa kluczowe

EN

knee; ACL; reconstruction; Internal Brace; muscle activity; muscle torque

• Wydawca: Oficyna Wydawnicza Politechniki Wrocławskiej
• Czasopismo: Acta of Bioengineering and Biomechanics
• Rocznik: 2025
• Tom: Vol. 27, no. 1
• Strony: 57--67
• Opis fizyczny: Bibliogr. 37 poz., rys., tab., wykr.

Twórcy

autor

Zalewska Paulina

• Institute of Biomedical Engineering, Bialystok University of Technology, Białystok, Poland.

autor

Góralczyk Adrian

• Humana Medica Omeda, Departament of Orthopaedics, Białystok, Poland.

autor

Guszczyn Tomasz

• The Medical University of Bialystok Children’s Clinical Hospital, Białystok, Poland.

autor

Hermanowicz Krzysztof

• ORTIM Orthopaedic Clinic, Białystok, Poland

autor

Piszczatowski Szczepan

• Institute of Biomedical Engineering, Bialystok University of Technology, Białystok, Poland.

Bibliografia

• [1] ABULHASAN J.F., GREY M.J., Anatomy and physiology of knee stability, J. Funct. Morphol. Kinesiol., 2017, 2 (4).
• [2] ADOUNI M., SHIRAZI-ADL A., MAROUANE H., Role of gastrocnemius activation in knee joint biomechanics: gastrocnemius acts as an ACL antagonist, Comput. Methods Biomech. Biomed. Engin., 2016, 19 (4), 376–385.
• [3] BRAM J.T., MAGEE L.C., MEHTA N.N., PATEL N.M., GANLEY T.J., Anterior Cruciate Ligament Injury Incidence in Adolescent Athletes: A Systematic Review and Meta-analysis, Am. J. Sports Med., 2021, 49 (7), 1962–1972.
• [4] BÜHL L., MÜLLER S., NÜESCH C., BOYER K.A., CASTO E., MÜNDERMANN A., EGLOFF C., Ambulatory knee biomechanics and muscle activity 2 years after ACL surgery: InternalBraceTM- -augmented ACL repair versus ACL reconstruction versus healthy controls, BMC Musculoskelet. Disord., 2023, 24 (1), 785.
• [5] CZAMARA A., Moments of muscular strength of knee joint extensors and flexors during physiotherapeutic procedures following anterior cruciate ligament reconstruction in males, Acta Bioeng. Biomech., 2008, 10 (3), 37–44.
• [6] DUJARDIN D., FONTANIN N., GEFFRIER A., MOREL N., MENSA C., OHL X., Muscle recovery after ACL reconstruction with 4-strand semitendinosus graft harvested through either a posterior or anterior incision: A preliminary study, Orthop. Traumatol. Surg. Res., 2015, 101 (5), 539–542.
• [7] EINARSSON E., THOMSON A., SAS B., HANSEN C.L., GISLASON M., WHITELEY R., Lower medial hamstring activity after ACL reconstruction during running: A cross-sectional study, BMJ Open Sport Exerc. Med., 2021, 7 (1), 1–5. Biomechanics of periarticular knee muscles after ACL surgery in young patients – comparison of autograft reconstruction… 67
• [8] VON ESSEN C., MCCALLUM S., ERIKSSON K., BARENIUS B., Minimal graft site morbidity using autogenous semitendinosus graft from the uninjured leg: a randomised controlled trial, Knee Surgery, Sport Traumatol. Arthrosc., 2022, 30 (5), 1639–1645.
• [9] GARCIA S.A., JOHNSON A.K., BROWN S.R., WASHABAUGH E.P., KRISHNAN C., PALMIERI-SMITH R.M., Dynamic knee stiffness during walking is increased in individuals with anterior cruciate ligament reconstruction, J. Biomech., 2023, 146, 111400.
• [10] GÓRALCZYK A., ZALEWSKA P., PISZCZATOWSKI S., HERMANOWICZ K., GUSZCZYN T., No difference in laxity, proprioception and neuromuscular control after suture-tape augmented ACL repair of acute proximal avulsions versus ACL reconstruction using hamstring autografts in young, active population, J. Exp. Orthop., 2024, 11 (3), e70025.
• [11] HARDY A., CASABIANCA L., ANDRIEU K., BAVEREL L., NOAILLES T., Complications following harvesting of patellar tendon or hamstring tendon grafts for anterior cruciate ligament reconstruction: Systematic review of literature, Orthop. Traumatol. Surg. Res., 2027, 103 (8), S245–S248.
• [12] HERMENS H., FRERIKS B., The state of the art on sensors and sensor placement procedures for surface electromyography, Roessingh Research and Development, 1997.
• [13] HEUSDENS C.H.W., Acl repair: A game changer or will history repeat itself? A critical appraisal, J. Clin. Med., 2021, 10 (5), 1–12.
• [14] HIEMSTRA L.A., WEBBER S., MACDONALD P.B., KRIELLAARS D.J., Contralateral limb strength deficits after anterior cruciate ligament reconstruction using a hamstring tendon graft, Clin. Biomech. (Bristol, Avon), 2007, 22 (5), 543–550.
• [15] HUBER R., VIECELLI C., BIZZINI M., FRIESENBICHLER B., DOHM-ACKER M., ROSENHECK T., HARDER L., MAFFIULETTI N.A., Knee extensor and flexor strength before and after anterior cruciate ligament reconstruction in a large sample of patients: influence of graft type, Phys. Sportsmed., 2019, 47 (1), 85–90.
• [16] IMRAN A., O’CONNOR J.J., Control of knee stability after ACL injury or repair: Interaction between hamstrings contraction and tibial translation, Clin. Biomech., 1998, 13 (3), 153–162.
• [17] MACKAY G.M., BLYTH M.J.G., ANTHONY I., HOPPER G.P., RIBBANS W.J., A review of ligament augmentation with the InternalBraceTM: the surgical principle is described for the lateral ankle ligament and ACL repair in particular, and a comprehensive review of other surgical applications and techniques is presented, Surg. Technol. Int., 2015, 26, 239–255.
• [18] MANIAR N., COLE M.H., BRYANT A.L., OPAR D.A., Muscle Force Contributions to Anterior Cruciate Ligament Loading, Sport Med., 2022, 52 (8), 1737–1750.
• [19] MANTASHLOO Z., LETAFATKAR A., MORADI M., Vertical ground reaction force and knee muscle activation asymmetries in patients with ACL reconstruction compared to healthy individuals, Knee Surgery, Sport Traumatol. Arthrosc., 2020, 28 (6), 2009–2014.
• [20] DU MOULIN W., BOURNE M., DIAMOND L.E., KONRATH J., VERTULLO C., LLOYD D., SAXBY D.J., Shape differences in the semitendinosus following tendon harvesting for anterior cruciate ligament reconstruction, J. Orthop. Res., 2022, 41 (1), 44–53.
• [21] MÜLLER S., BÜHL L., NÜESCH C., PAGENSTERT G., MÜNDERMANN A., EGLOFF C., Favorable Patient-Reported, Clinical, and Functional Outcomes 2 Years After ACL Repair and InternalBrace Augmentation Compared With ACL Reconstruction and Healthy Controls, Am. J. Sports Med., 2023, 51 (12), 3131–3141.
• [22] MURRAY M.M., Optimizing outcomes of ACL surgery – Is autograft reconstruction the only reasonable option?, J. Orthop. Res. Off Publ. Orthop. Res. Soc., 2021, 39 (9), 1843–1850.
• [23] PACHE S., DEL CASTILLO J., MOATSHE G., LAPRADE R.F., Anterior cruciate ligament reconstruction failure and revision surgery: Current concepts, J. ISAKOS, 2020, 5 (6), 351–358.
• [24] PAIROT DE FONTENAY B., ARGAUD S., BLACHE Y., MONTEIL K., Contralateral limb deficit seven months after ACL-reconstruction: an analysis of single-leg hop tests, Knee, 2015, 22 (4), 309–312.
• [25] PALMIERI-SMITH R.M., LEPLEY L.K., Quadriceps strength asymmetry after anterior cruciate ligament reconstruction alters knee joint biomechanics and functional performance at time of return to activity, Am. J. Sports Med., 2015, 43 (7), 1662–1669.
• [26] PANG L., LI P., LI T., LI Y., ZHU J., TANG X., Arthroscopic Anterior Cruciate Ligament Repair Versus Autograft Anterior Cruciate Ligament Reconstruction: A Meta-Analysis of Comparative Studies, Front. Surg., 2022, 20, 9, 887522.
• [27] PEEL S.A., SCHROEDER L.E., WEINHANDL J.T., Lower extremity muscle contributions to ACL loading during a stop-jump task, J. Biomech., 2021, 121, 110426.
• [28] RHIM H.C., LEE J.H., HAN S.B., SHIN K.H., SUH D.W., JANG K.M., Role of the triceps surae muscles in patients undergoing anterior cruciate ligament reconstruction: A matched case-control study, J. Clin. Med., 2020, 9 (10), 1–11.
• [29] SANADA T., IWASO H., FUKAI A., HONDA E., YOSHITOMI H., INAGAWA M., Anatomic Anterior Cruciate Ligament Reconstruction Using Rectangular Bone–Tendon–Bone Autograft versus Double–Bundle Hamstring Tendon Autograft in Young Female Athletes, Arthrosc. Sport Med. Rehabil., 2021, 3 (1), e47–e55.
• [30] SHANBEHZADEH S., MOHSENI BANDPEI M.A., EHSANI F., Knee muscle activity during gait in patients with anterior cruciate ligament injury: a systematic review of electromyographic studies, Knee Surg. Sports Traumatol. Arthrosc., 2017, 25 (5), 1432–1442.
• [31] SHARIFI M., SHIRAZI-ADL A., Knee flexion angle and muscle activations control the stability of an anterior cruciate ligament deficient joint in gait, J. Biomech., 2021, 117.
• [32] SHARIFI M., SHIRAZI-ADL A., MAROUANE H., Computational stability of human knee joint at early stance in Gait: Effects of muscle coactivity and anterior cruciate ligament deficiency, J. Biomech., 2017, 63, 110–116.
• [33] SØRENSEN B., AAGAARD P., MALCHOW-MØLLER L., ZEBIS M.K., BENCKE J., Medio-lateral hamstring muscle activity in unilateral vs. Bilateral strength exercises in female team handball players – a cross-sectional study, Int. J. Sports Phys. Ther., 2021, 16 (3), 704–714.
• [34] STEWART C., SHORTLAND A.P., The biomechanics of pathological gait – from muscle to movement, Acta Bioeng. Biomech., 2010, 12 (3), 3–12.
• [35] THOMEÉ R., KAPLAN Y., KVIST J., MYKLEBUST G., RISBERG M.A., THEISEN D., TSEPIS E., WERNER S., WONDRASCH B., WITVROUW E., Muscle strength and hop performance criteria prior to return to sports after ACL reconstruction, Knee Surg. Sports Traumatol. Arthrosc., 2011, 19 (11), 1798–1805.
• [36] WELLSANDT E,, FAILLA M,J,, SNYDER-MACKLER L., Limb Symmetry Indexes Can Overestimate Knee Function After Anterior Cruciate Ligament Injury, J. Orthop. Sports Phys. Ther., 2017, 47 (5), 334–338.
• [37] WILSON W.T., HOPPER G.P., BANGER M.S., BLYTH M..JG., RICHES P.E., MACKAY G.M., Anterior cruciate ligament repair with internal brace augmentation: A systematic review, Knee, 2022, 35, 192–200.