Étude préliminaire de la désadaptation cardiorespiratoire après une ligamentoplastie de genou chez le sportif

Effects of running retraining after knee anterior cruciate ligament reconstruction

OBJECTIVE

The aim of this study was to analyze the effect of running retraining on the recovery of the knee's functional and muscular properties after anterior cruciate ligament (ACL) reconstruction.

METHODS

Eighty-five athletes who had undergone ACL reconstruction surgery were selected randomly to receive, or not to receive, controlled running training based on interval training and speed exercises. The effect of retraining was measured by the evolution of the knee's isokinetic strength deficit and progress (at angular speeds of 60 and 180 degrees /s), the knee laxity parameters and the score on the Lysholm Knee Scale from the 4th to the 6th month after the surgery. Forty subjects were retrained and compared with 40 control-group subjects. The effect of the retraining program was studied in terms of the type of ACL reconstruction and the effect of time.

RESULTS

After retraining, no difference was found for isokinetic knee strength deficit and progress, knee laxity and Lysholm Knee Score. The isokinetic strength deficit was influenced mainly by the type of ACL reconstruction.

CONCLUSION

It would seem that running retraining has an insufficient effect on the muscular and functional recovery after ACL reconstruction, despite the fact that this type of training is well-tolerated.

[One-leg cycling aerobic training with the healthy leg in amateur soccer players after anterior cruciate ligament reconstruction]

OBJECTIVE

To examine cardiorespiratory fitness changes in subjects having undergone knee surgery and to assess the benefits of one-leg cycling aerobic training program during the rehabilitation period.

METHOD

Two groups of 12 patients took part in this study. The control group profited from a five weeks conventional rehabilitation in day hospital without cardiorespiratory training. The second group profited in supplement from a one-leg cycling aerobic training program with the valid leg. The subjects were trained for 21 min, by alternating 3 min at 70% and 3 min at 85% of VO(2 peak). They totaled 15 sessions spread over five weeks. The initial evaluation (T1) is carried out the first day of rehabilitation and the final evaluation (T2) at a distance within 35 days. The evaluation consisted in realizing a maximal graded tests starting from the valid leg.

RESULTS

After five weeks of conventional rehabilitation, we record a reduction of peak power output (W(peak)), peak oxygen uptake (VO(2 peak)) and peak minute ventilation (VE(peak)), respectively of 11, 12 and 13% for the control group. On the other hand, in T2, the training group has on average identical maximum values and some of them increased (W(peak): +14%; VE(peak): +15%). The first and second ventilatory thresholds appear with higher intensities of exercises.

CONCLUSION

After knee surgery, conventional rehabilitation does not limit cardiorespiratory deconditioning. One leg cycling appears to be an adapted method to stop the effects of hypoactivity.

[Isokinetic, functional and proprioceptive assessment of soccer players two years after surgical reconstruction of the anterior cruciate ligament of the knee]

Injuries to the anterior cruciate ligament (ACL) of the knee are common in sport and are treated routinely in the world of sports medicine. In order to resume competitive sport in safety, it is important to know the actual level of performance achieved by the operated leg some time after the ligament repair.

OBJECTIVES

The objective of this work was to evaluate the recovery of the operated leg in Tunisian sportsmen two years after surgery by using isokinetic testing (60 degrees s(-1)), the one-leg hop distance test (i.e. a functional activity that one often finds in sport) and proprioceptive assessment. A secondary objective was to detect any possible correlations between the various outcomes.

MATERIALS AND METHOD

The ACL group was composed of 26 top-level Tunisian footballers having undergone ACL ligament repair. Two years after surgery, the following assessments were performed: an isokinetic test with an angular velocity of 60 degrees s(-1), a proprioceptive assessment in both active and passive modes and the functional one-leg hop distance test.

RESULTS

Our investigations confirmed a muscle deficit of 16% in the hamstring muscles of the injured leg. In both active and passive modes, normal proprioception is observed at a flexion of 60 degrees and in total extension but not in a mid-way position. The performance level of the operated leg (in terms of distance) had an average symmetry value of 93.40+/-2.7%.

CONCLUSION

Playing football appears to influence the isokinetic strength profile in sportsmen after ACL repair. The repair procedure leads to bilateral proprioceptive disruption at 15 degrees of knee flexion, on average.