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dc.contributor.authorEbert, J.
dc.contributor.authorSmith, Anne
dc.contributor.authorEdwards, P.
dc.contributor.authorAckland, T.
dc.date.accessioned2017-01-30T14:27:52Z
dc.date.available2017-01-30T14:27:52Z
dc.date.created2014-09-23T20:00:17Z
dc.date.issued2014
dc.identifier.citationEbert, J. and Smith, A. and Edwards, P. and Ackland, T. 2014. The progression of isokinetic knee strength after matrix-induced autologous chondrocyte implantation: implications for rehabilitation and return to activity. Journal of Sport Rehabilitation. 23 (3): pp. 244-258.
dc.identifier.urihttp://hdl.handle.net/20.500.11937/38916
dc.identifier.doi10.1123/JSR.2014-0159
dc.description.abstract

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.

dc.publisherHuman Kinetics Publishers INC
dc.subjectcartilage repair
dc.subjectrecovery
dc.subjectreturn to sport
dc.subjectknee function
dc.titleThe progression of isokinetic knee strength after matrix-induced autologous chondrocyte implantation: implications for rehabilitation and return to activity
dc.typeJournal Article
dcterms.source.volume23
dcterms.source.startPage244
dcterms.source.endPage258
dcterms.source.issn10566716
dcterms.source.titleJournal of Sport Rehabilitation
curtin.note

Copyright © 2014 Human Kinetics, as accepted for publication

curtin.note

NOTICE: This is the author’s version of a work in which changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication.

curtin.departmentSchool of Physiotherapy
curtin.accessStatusOpen access


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