The progression of isokinetic knee strength after matrix-induced autologous chondrocyte implantation: implications for rehabilitation and return to activity
Context: Matrix-induced autologous chondrocyte implantation (MACI) is an established technique for the repair of knee chondral defects. Despite the reported clinical improvement in knee pain and symptoms, little is known on the recovery of knee strength and its return to an appropriate level compare...
| Main Authors: | , , , |
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| Format: | Journal Article |
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Human Kinetics Publishers INC
2014
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| Online Access: | http://hdl.handle.net/20.500.11937/38916 |
| _version_ | 1848755448978604032 |
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| author | Ebert, J. Smith, Anne Edwards, P. Ackland, T. |
| author_facet | Ebert, J. Smith, Anne Edwards, P. Ackland, T. |
| author_sort | Ebert, J. |
| building | Curtin Institutional Repository |
| collection | Online Access |
| description | Context: Matrix-induced autologous chondrocyte implantation (MACI) is an established technique for the repair of knee chondral defects. Despite the reported clinical improvement in knee pain and symptoms, little is known on the recovery of knee strength and its return to an appropriate level compared with the unaffected limb. Objective: To investigate the progression of isokinetic knee strength and limb symmetry after MACI. Design: Prospective cohort. Setting: Private functional rehabilitation facility. Patients: 58 patients treated with MACI for full-thickness cartilage defects to the femoral condyles. Intervention: MACI and a standardized rehabilitation protocol. Main Outcome Measures: Preoperatively and at 1, 2, and 5 y postsurgery, patients underwent a 3-repetition-maximum straight-leg raise test, as well as assessment of isokinetic knee-flexor and -extensor torque and hamstring: quadriceps (H:Q) ratios. Correlation analysis investigated the association between strength and pain, demographics, defect, and surgery characteristics. Linear-regression analysis estimated differences in strength measures between the operated and nonoperated limbs, as well as Limb Symmetry Indexes (LSI) over time.Results: Peak knee-extension torque improved significantly over time for both limbs but was significantly lower on the operated limb preoperatively and at 1, 2, and 5 y. Mean LSIs of 77.0%, 83.0%, and 86.5% were observed at 1, 2, and 5 y, respectively, while 53.4–72.4% of patients demonstrated an LSI ≤ 90% across the postoperative timeline. Peak knee-flexion torque was significantly lower on the operated limb preoperatively and at 1 year. H:Q ratios were significantly higher on the operated limb at all time points. Conclusions: While peak knee-flexion and hip-flexor strength were within normal limits, the majority of patients in this study still demonstrated an LSI for peak knee-extensor strength ≤ 90%, even at 5 y. It is unknown how this prolonged knee-extensor deficit may affect long-term graft outcome and risk of reinjury after return to activity. |
| first_indexed | 2025-11-14T08:56:28Z |
| format | Journal Article |
| id | curtin-20.500.11937-38916 |
| institution | Curtin University Malaysia |
| institution_category | Local University |
| last_indexed | 2025-11-14T08:56:28Z |
| publishDate | 2014 |
| publisher | Human Kinetics Publishers INC |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | curtin-20.500.11937-389162017-09-13T14:22:15Z The progression of isokinetic knee strength after matrix-induced autologous chondrocyte implantation: implications for rehabilitation and return to activity Ebert, J. Smith, Anne Edwards, P. Ackland, T. cartilage repair recovery return to sport knee function Context: Matrix-induced autologous chondrocyte implantation (MACI) is an established technique for the repair of knee chondral defects. Despite the reported clinical improvement in knee pain and symptoms, little is known on the recovery of knee strength and its return to an appropriate level compared with the unaffected limb. Objective: To investigate the progression of isokinetic knee strength and limb symmetry after MACI. Design: Prospective cohort. Setting: Private functional rehabilitation facility. Patients: 58 patients treated with MACI for full-thickness cartilage defects to the femoral condyles. Intervention: MACI and a standardized rehabilitation protocol. Main Outcome Measures: Preoperatively and at 1, 2, and 5 y postsurgery, patients underwent a 3-repetition-maximum straight-leg raise test, as well as assessment of isokinetic knee-flexor and -extensor torque and hamstring: quadriceps (H:Q) ratios. Correlation analysis investigated the association between strength and pain, demographics, defect, and surgery characteristics. Linear-regression analysis estimated differences in strength measures between the operated and nonoperated limbs, as well as Limb Symmetry Indexes (LSI) over time.Results: Peak knee-extension torque improved significantly over time for both limbs but was significantly lower on the operated limb preoperatively and at 1, 2, and 5 y. Mean LSIs of 77.0%, 83.0%, and 86.5% were observed at 1, 2, and 5 y, respectively, while 53.4–72.4% of patients demonstrated an LSI ≤ 90% across the postoperative timeline. Peak knee-flexion torque was significantly lower on the operated limb preoperatively and at 1 year. H:Q ratios were significantly higher on the operated limb at all time points. Conclusions: While peak knee-flexion and hip-flexor strength were within normal limits, the majority of patients in this study still demonstrated an LSI for peak knee-extensor strength ≤ 90%, even at 5 y. It is unknown how this prolonged knee-extensor deficit may affect long-term graft outcome and risk of reinjury after return to activity. 2014 Journal Article http://hdl.handle.net/20.500.11937/38916 10.1123/JSR.2014-0159 Human Kinetics Publishers INC fulltext |
| spellingShingle | cartilage repair recovery return to sport knee function Ebert, J. Smith, Anne Edwards, P. Ackland, T. The progression of isokinetic knee strength after matrix-induced autologous chondrocyte implantation: implications for rehabilitation and return to activity |
| title | The progression of isokinetic knee strength after matrix-induced autologous chondrocyte implantation: implications for rehabilitation and return to activity |
| title_full | The progression of isokinetic knee strength after matrix-induced autologous chondrocyte implantation: implications for rehabilitation and return to activity |
| title_fullStr | The progression of isokinetic knee strength after matrix-induced autologous chondrocyte implantation: implications for rehabilitation and return to activity |
| title_full_unstemmed | The progression of isokinetic knee strength after matrix-induced autologous chondrocyte implantation: implications for rehabilitation and return to activity |
| title_short | The progression of isokinetic knee strength after matrix-induced autologous chondrocyte implantation: implications for rehabilitation and return to activity |
| title_sort | progression of isokinetic knee strength after matrix-induced autologous chondrocyte implantation: implications for rehabilitation and return to activity |
| topic | cartilage repair recovery return to sport knee function |
| url | http://hdl.handle.net/20.500.11937/38916 |