Isokinetic evaluation of anterior cruciate ligament reconstruction using a free fascia lata graft strengthened by gracilis tendon

Anterior cruciate ligament (ACL) reconstruction is used to restore knee stability. Objective: To evaluate the functional outcomes following anterior cruciate ligament reconstruction using a free fascia lata graft strengthened by gracilis tendon. Methods: 60 patients met the inclusion criteria (age over 16, minimum 1 year follow-up). The isokinetic test on Cybex II consist of a concentric evaluation at 60°/s, 180°/s and 240°/s and an eccentric one at 30°/s. A Satisfaction index, Lysholm-Tegner score and IKDC score completed the evaluation. Results: 55 patients were examined (91.6%), mean age 31 years, 69% of men and a mean follow up of 30 months; only 50 had isokinetic test. 81.8% were really/very satisfied. Mean Lysholm knee score is 96/100 with 93% of excellent and good results; mean Tegner activity level is 7 (8 before ACL injury) with 71% return to their previous sport level. IKDC global score noted 98% of good (22% B grade) and very good (76% A grade) results. In concentric test, 56% of patients have a hamstring muscle strength loss, with a mean deficit of 9% at 60°/s and 8.8% at 180°/s; 76% had a quadriceps strength loss, with a mean deficit of 15% at 60°/s and 11% at 180°/s. The hamstring and quadriceps deficit is around 9% in eccentric test. The ratio hamstring/quadriceps are symmetrical between the treated knee and the healthy one. No significant difference is related. Discussion-Conclusion: These results are in accordance with the principal series in the literature. The agonist-antagonist muscular obtained balance shows a fearly good analytical muscular recovery. The functional outcomes agree with other studies. Thus, this technique of anterior cruciate ligament reconstruction is reliable, respect extensor system and does not disturb hamstring muscle recovery.