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Titre de l’article Subjective knee apprehension after anterior cruciate ligament reconstruction is not correlated with muscle strength, balance and stability.
Code d’article P36
Auteurs
  1. Morgan Gauthier Hôpitaux Universitaires de Genève Conférencier
  2. Antonia Wehn Hôpitaux Universitaire de Genève
  3. Philippe M. Tscholl Hôpitaux universitaires de Genève (HUG)
Forme de présentation Poster
Domaines thématiques
  • A05 - Genou
Résumé (Abstract) Introduction
Anterior cruciate ligament (ACL) reconstruction is performed with aim to return to sport (RTS) and lower the risk of further knee injury. RTS is found in 82% athletes, however only 50% still perform at the same level, although rerupture rate is low. Inadequate rehabilitation, muscle weakness, poor movement quality have shown to be risk factors for rerupture. Knee apprehension is important to assess before RTS, which can be evaluated with ACL-RSI score. Sport testing battery is another element to consider, including muscle strength, balance and stability. Purpose of this study was to observe if there was a correlation between knee apprehension with ACL-RSI and sport testing battery after ACL reconstruction.

Methods
All patients treated operatively for ACL injury between 2013 and 2020 were reviewed in this study. Only patients performing 2 sport testing battery were included. Knee apprehension was measured using ACL-RSI score at 6 and 12 months. Sport testing battery was performed at 8 and 12 months. Muscle strength was evaluated by isokinetic test for quadriceps and hamstring. Balance was assessed with SEBT, side hop test, and triple hop test. Stability was assessed by laximetry with GNRB.

Results
57 patients were included in this study (42 men, 15 women). Mean duration between ACL rupture and surgery was 4 months. The first test was performed at 8 months and the second at 12 months after surgery.
ACL-RSI was 56 ± 25 in the first test, where men showed a slightly higher score (58 ± 26) compared to women (51 ± 26), however not significantly (p = 0.42). The overall score was increased after the second test to 64 ± 31, in women (65 ± 34) more than in men (63 ± 24).
20 patients (35%) showed initially an ACL-RSI < 50 and 11 (19%) an ACL-RSI score >75. After second test, only 8 (14%) remained below ACL-RSI of 50, whereas 20 (35%) were above 75. However, this increase in patient reported outcome was not significantly linked to an increase in muscle strength and jumping exercises.
Correlative analysis also revealed no correlation between ACL-RSI and GNRB or muscle strength.

Conclusion
ACL reconstruction showed improvement in knee apprehension measured with ACL-RSI, which increased over time. However, there was no correlation between ACL-RSI and sport testing battery. Hence, evaluation of psychological factors contributing to knee apprehension and physical factors such as muscle strength, balance and stability are important to consider before RTS.