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

Müller, Sebastian ; Hirschmüller, Anja ; Erggelet, Christoph ; Beckmann, Nicholas ; Kreuz, Peter

In: Knee Surgery, Sports Traumatology, Arthroscopy, 2015, vol. 23, no. 8, p. 2151-2158

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    Titre
    • Significantly worse isokinetic hamstring-quadriceps ratio in patellofemoral compared to condylar defects 4years after autologous chondrocyte implantation
    Auteur
    • Müller, Sebastian. Department of Traumatology, University Hospital Basel, Spitalstrasse 21, 4031, Basel, Switzerland
    • Hirschmüller, Anja. Department of Orthopaedics and Traumatology, University Hospital Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany
    • Erggelet, Christoph. Department of Orthopaedics and Traumatology, University Hospital Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany
    • Beckmann, Nicholas. Department of Orthopaedics and Trauma Surgery, University Hospital Heidelberg, Schlierbacher Landstraße 200a, 69118, Heidelberg, Germany
    • Kreuz, Peter. Department of Orthopaedic Surgery, University Medical Center Rostock, Doberanerstr. 142, 18057, Rostock, Germany
    Type de document
    • Postprint
    Langue
    • Inglese
    Publié dans
    • Knee Surgery, Sports Traumatology, Arthroscopy, 2015, vol. 23, no. 8, p. 2151-2158. Springer Berlin Heidelberg
    Autre version électronique
    Identifiant OAI-PMH
    • oai:doc.rero.ch:332304
    Summary
    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 4years 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 48months after implantation using the International Knee Documentation Committee (IKDC) score and the International Cartilage Repair Society (ICRS) form. Isokinetic strength measurements were performed 48months 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 4years 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: II.