Suggestions from a recentely published paper in British Journal of Sports Medicine sounds that reconstructive surgery should not be performed before quadriceps muscle strength deficits of the injured limb is less than 20% of the uninjured limb.
The purpose of this prospective cohort study was to identify preoperative predictive factors for knee function two years after reconstructive surgery of the anterior cruciate ligament (ACL).
Seventy-three individuals with complete unilateral rupture of the ACL scheduled for ACL reconstruction with a bone-patellar-bone autograft were included in the study, from where sixty were available for two-year follow up and included in the final analyses.
The results reveal that quadriceps muscle strength, meniscus injury and The Short-Form-36 Bodily Pain questionnaire sub score were identified as significant predictors for knee function assessed from The Cincinnati Knee Score two years after surgery. Individuals with preoperative quadriceps strength deficits above 20% also had persistent significantly larger strength deficits two years after surgery.
From this, it is concluded that preoperative quadriceps muscle strength deficits and meniscus injuries have significant negative consequences for the long-term functional outcome after ACL reconstruction.
This project has been carried out by Ingrid Eitzen, Inger Holm and May Arna Risberg, all of them working at Norwegian Center of Active Rehabilitation (NAR).
Read the paper.