{"title":"Postoperative Knee Extensor Strength After Medial Patellofemoral Ligament Reconstruction Using Superficial Slip of the Quadriceps Tendon and the Factors That Affect Strength Recovery.","authors":"Chiharu Inoue, Yoshimitsu Aoki, Kazunori Yasuda, Eiji Kondo, Satoru Kaneko, Harukazu Tohyama, Masayuki Inoue, Tomononori Yagi","doi":"10.1177/23259671251325748","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Medial patellofemoral ligament reconstruction (MPFLR) using the quadriceps tendon can avoid complications related to the fixation of other graft types to the patella. However, there is concern about postoperative loss of knee extensor muscle strength because of harvesting a portion of the quadriceps tendon.</p><p><strong>Hypothesis: </strong>Knee extensor muscle strength after superficial slip of the quadriceps tendon MPFLR (SQ-MPFLR) decreases postoperatively, and there are specific factors that effect knee extensor muscle strength recovery.</p><p><strong>Study design: </strong>Case series study; Level of evidence 4.</p><p><strong>Methods: </strong>A total of 26 patients who underwent unilateral primary SQ-MPFLR were enrolled. Clinical and functional outcomes were evaluated using the Kujala score and Tegner activity score preoperatively and 12 months postoperatively. Knee extensor muscle strength was examined preoperatively and 6 and 12 months postoperatively using the Biodex dynamometer. The knee muscle strength of the operated leg was compared with that of the contralateral leg using the limb symmetry index (LSI). The associations of sex, body mass index, and daily sports activity level with knee extensor muscle strengths at 6 and 12 months postoperatively were investigated and compared between the 2 groups.</p><p><strong>Results: </strong>The preoperative mean Kujala score was 65.0 and significantly improved to 94.7 at 12 months after surgery (<i>P</i> < .001). The preoperative Tegner activity score was 5.6, and the 12-month postoperative score was 5.8. The knee extensor LSI increased from 69.2% preoperatively to 82.0% at 12 months postoperatively. The patient group with a high sports activity level had a significant higher knee extensor muscle LSI (mean, 87.8%) than the group with a low sports activity level at 12 months postoperatively (<i>P</i> = .003).</p><p><strong>Conclusion: </strong>The knee extensor LSI of patients who underwent SQ-MPFLR increased from 69.2% preoperatively to 82.0% postoperatively at 12 months. The patient group with a high sports activity level had a significantly higher knee extensor LSI than the group with a low sports activity level at 12 months after SQ-MPFLR surgery.</p>","PeriodicalId":19646,"journal":{"name":"Orthopaedic Journal of Sports Medicine","volume":"13 4","pages":"23259671251325748"},"PeriodicalIF":2.4000,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11970040/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Orthopaedic Journal of Sports Medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1177/23259671251325748","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/4/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
Postoperative Knee Extensor Strength After Medial Patellofemoral Ligament Reconstruction Using Superficial Slip of the Quadriceps Tendon and the Factors That Affect Strength Recovery.
Background: Medial patellofemoral ligament reconstruction (MPFLR) using the quadriceps tendon can avoid complications related to the fixation of other graft types to the patella. However, there is concern about postoperative loss of knee extensor muscle strength because of harvesting a portion of the quadriceps tendon.
Hypothesis: Knee extensor muscle strength after superficial slip of the quadriceps tendon MPFLR (SQ-MPFLR) decreases postoperatively, and there are specific factors that effect knee extensor muscle strength recovery.
Study design: Case series study; Level of evidence 4.
Methods: A total of 26 patients who underwent unilateral primary SQ-MPFLR were enrolled. Clinical and functional outcomes were evaluated using the Kujala score and Tegner activity score preoperatively and 12 months postoperatively. Knee extensor muscle strength was examined preoperatively and 6 and 12 months postoperatively using the Biodex dynamometer. The knee muscle strength of the operated leg was compared with that of the contralateral leg using the limb symmetry index (LSI). The associations of sex, body mass index, and daily sports activity level with knee extensor muscle strengths at 6 and 12 months postoperatively were investigated and compared between the 2 groups.
Results: The preoperative mean Kujala score was 65.0 and significantly improved to 94.7 at 12 months after surgery (P < .001). The preoperative Tegner activity score was 5.6, and the 12-month postoperative score was 5.8. The knee extensor LSI increased from 69.2% preoperatively to 82.0% at 12 months postoperatively. The patient group with a high sports activity level had a significant higher knee extensor muscle LSI (mean, 87.8%) than the group with a low sports activity level at 12 months postoperatively (P = .003).
Conclusion: The knee extensor LSI of patients who underwent SQ-MPFLR increased from 69.2% preoperatively to 82.0% postoperatively at 12 months. The patient group with a high sports activity level had a significantly higher knee extensor LSI than the group with a low sports activity level at 12 months after SQ-MPFLR surgery.
期刊介绍：
The Orthopaedic Journal of Sports Medicine (OJSM), developed by the American Orthopaedic Society for Sports Medicine (AOSSM), is a global, peer-reviewed, open access journal that combines the interests of researchers and clinical practitioners across orthopaedic sports medicine, arthroscopy, and knee arthroplasty.
Topics include original research in the areas of:
-Orthopaedic Sports Medicine, including surgical and nonsurgical treatment of orthopaedic sports injuries
-Arthroscopic Surgery (Shoulder/Elbow/Wrist/Hip/Knee/Ankle/Foot)
-Relevant translational research
-Sports traumatology/epidemiology
-Knee and shoulder arthroplasty
The OJSM also publishes relevant systematic reviews and meta-analyses.
This journal is a member of the Committee on Publication Ethics (COPE).
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