The Relationship Between Joint Awareness and Muscle Strength, Return to Sports and Quality of Life After ACL-R Surgery in Recreational Athletes: A Cross-Sectional Study

The Relationship Between Joint Awareness and Muscle Strength, Return to Sports and Quality of Life After ACL-R Surgery in Recreational Athletes: A Cross-Sectional Study

Objectives:The aim of this study was to investigate the relationship between joint awareness, muscle strength, return to sports and quality of life in patients with anterior cruciate ligament reconstruction (ACL-R) with hamstring tendon autografts.Patients and Methods:Aged between 18-40 years 23 patients with ACL-R at least one year after the surgery participated in the present study. Muscle strength was measured with ISOMED 2000 isokinetic dynamometer. Joint awareness, quality of life and return to sport were evaluated respectively by using Forgotten Joint Score (FJS), Anterior Cruciate Ligament-Quality of Life Questionnaire (ACL-QoL) and Anterior Cruciate Ligament-Return to sport after Injury (ACL-RSI).’Results:There was a moderate correlation between FJS-12 with ACL-RSI (r=0.441; p=0.035), and ACL-QoL scores (r=0.505; p=0.014). A strong positive correlation was found between ACL-RSI and ACL-QoL scores (r=0.827; p0.05).Conclusion:This current study showed that joint awareness was related to return to sports and quality of life in the long term following ACL-R. In conclusion, we recommend minimizing joint awareness for a better quality of life and returning to sports

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  • 1. Spindler KP, Wright RW. Anterior cruciate ligament tear. N Engl J Med 2008;359:2135–2142. [CrossRef]
  • 2. Salzler M, Nwachukwu BU, Rosas S, et al. State-of-the-art anterior cruciate ligament tears: A primer for primary care physicians. Physician Sportsmed 2015;43:169–177. [CrossRef]
  • 3. Ageberg E, Roos HP, Silbernagel KG, Thomeé R, Roos EM. Knee extension and flexion muscle power after anterior cruciate ligament reconstruction with patellar tendon graft or hamstring tendons graft: a cross-sectional comparison 3 years post surgery. Knee Surg Sports Traumatol Arthrosc 2009;17:162–169. [CrossRef]
  • 4. Petersen W, Taheri P, Forkel P, Zantop T. Return to play following ACL reconstruction: a systematic review about strength deficits. Arch Orthop Trauma Surg 2014;134:1417–1428. [CrossRef]
  • 5. Filbay SR, Ackerman IN, Dhupelia S, Arden NK, Crossley KM. Quality of life in symptomatic individuals after anterior cruciate ligament reconstruction, with and without radiographic knee osteoarthritis. J Orthop Sports Phys Ther 2018;48:398–408. [CrossRef]
  • 6. Behrend H, Zdravkovic V, Giesinger JM, Giesinger K. Joint awareness after ACL reconstruction: patient-reported outcomes measured with the Forgotten Joint Score-12. Knee Surg Sports Traumatol Arthrosc 2017;25:1454–1460. [CrossRef]
  • 7. Behrend H, Giesinger K, Giesinger JM, Kuster MS. The “forgotten joint” as the ultimate goal in joint arthroplasty: validation of a new patient-reported outcome measure. J Arthroplasty 2012;27:430–436.e1. [CrossRef]
  • 8. Kınıklı Gİ, Deniz HG, Karahan S, et al. Validity and reliability of Turkish version of the Forgotten Joint Score-12. J Exerc Ther Rehabil 2017;4:18–25. http://www.jetr.org.tr/wp-content/uploads/JETR4_1_3_gizem_irem_kinikli.pdf
  • 9. Grbic V, Djuric S, Knezevic OM, Mirkov DM, Nedeljkovic A, Jaric S. A novel two-velocity method for elaborate isokinetic testing of knee extensors. Int J Sports Med 2017;38:741–746. [CrossRef]
  • 10. Zemach L, Almoznino S, Barak Y, Dvir Z. Quadriceps insufficiency in patients with knee compromise: How many velocities should an isokinetic test protocol consist of? Isokinetics Exerc Sci 2009;17:129–133. [CrossRef]
  • 11. Harput G, Tok D, Ulusoy B, et al. Translation and cross-cultural adaptation of the anterior cruciate ligament-return to sport after injury (ACL-RSI) scale into Turkish. Knee Surg Sports Traumatol Arthrosc 2017;25:159–164. [CrossRef]
  • 12. Kinikli GI, Celik D, Yuksel I, Atay OA. Turkish version of the anterior cruciate ligament quality of life questionnaire. Knee Surg Sports Traumatol Arthrosc 2015;23:2367–2375. [CrossRef]
  • 13. Behrend H, Giesinger K, Zdravkovic V, Giesinger JM. Validating the forgotten joint score-12 in patients after ACL reconstruction. Knee 2017;24:768–774. [CrossRef]
  • 14. Sadeqi M, Klouche S, Bohu Y, Herman S, Lefevre N, Gerometta A. Progression of the psychological ACL-RSI score and return to sport after anterior cruciate ligament reconstruction: a prospective 2-year follow-up study from the French Prospective Anterior Cruciate Ligament Reconstruction Cohort Study (FAST). Orthop J Sports Med 2018;6:2325967118812819. [CrossRef]
  • 15. Meierbachtol A, Yungtum W, Paur E, Bottoms J, Chmielewski TL. Psychological and functional readiness for sport following advanced group training in patients with anterior cruciate ligament reconstruction. J Orthop Sports Phys Ther 2018;48:864–872. [CrossRef]
  • 16. Ardern CL, Taylor NF, Feller JA, Whitehead TS, Webster KE. Psychological responses matter in returning to preinjury level of sport after anterior cruciate ligament reconstruction surgery. Am J Sports Med 2013;41:1549–1558. [CrossRef]
  • 17. Gokeler A, Welling W, Zaffagnini S, Seil R, Padua D. Development of a test battery to enhance safe return to sports after anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc 2017;25:192–199. [CrossRef]
  • 18. Müller U, Krüger-Franke M, Schmidt M, Rosemeyer B. Predictive parameters for return to pre-injury level of sport 6 months following anterior cruciate ligament reconstruction surgery. Knee Surg Sports Traumatol Arthrosc 2015;23:3623–3631. [CrossRef]
  • 19. Ardern CL, Glasgow P, Schneiders A, et al. 2016 Consensus statement on return to sport from the First World Congress in Sports Physical Therapy, Bern. Br J Sports Med 2016;50:853–864. [CrossRef]
  • 20. Lafave MR, Hiemstra L, Kerslake S, Heard M, Buchko G. Validity, reliability, and responsiveness of the anterior cruciate ligament quality of life measure: a continuation of its overall validation. Clin J Sport Med 2017;27:57–63. [CrossRef]
  • 21. Leiter JR, Gourlay R, McRae S, de Korompay N, MacDonald PB. Long-term follow-up of ACL reconstruction with hamstring autograft. Knee Surg Sports Traumatol Arthrosc 2014;22:1061–1069. [CrossRef]