General Teaching Hospital Celje, Slovenia
Matjaz Sajovic is a senior orthopaedic surgeon and currently a Deputy Head of Department of Orthopedics and Sports Trauma Surgery at General Teaching Hospital Celje, Slovenia. He is also a Lecturer at Medical University of Maribor, Slovenia. In his youth he was a representative of former Yugoslavia in gymnastics and athletic decathlon. He received his MD degree at Medical University of Ljubljana in 1985. He has also received his PhD at Medical University of Maribor in 2010. In early years of 1990 he developed Accelerated Rehabilitation Protocol after ligament reconstruction. The protocol is still in use with minor changes. In past 20 years he operatively focused on sports injuries and rehabilitation after operative procedures. He actively cooperates with Slovenian Ski Team, Slovenian Judo team and Slovenian Handball Team. He is active participant and invited speaker on many world congresses and international orthopedic Symposia. He published many scientific papers in various World known and national Journals.
Purpose: The most frequently used grafts for intra-articular anterior cruciate ligament (ACL) reconstruction are the autologous patellar tendon (PT) or doubled semitendinosus and gracilis tendons (STG) autografts. There are still controversies about graft selection for primary ACL reconstruction.
Methods: A prospective, randomized study was conducted on 57 patients who underwent arthroscopically assisted ACL reconstruction between January 2010 and February 2011. In 29 patients ACL reconstruction was performed with hamstring tendon autograft (STG group), and in 28 patients the ACL reconstruction was performed with patellar tendon autograft (PT group). At 6 months follow-up, all patients have performed the isokinetic extensor and flexor muscles strength and KT-1000 measurements.
Results: In the STG group, the average deficit of peak extensor torque at angular velocity of 60°/s was 14.0%. The average peak flexor torque of the involved leg in the STG group was 96% of peak flexor torque of the uninvolved leg. In the PT group, the average deficit of peak extensor torque was 26.7% and the average deficit of peak flexor torque was minimal (1.4%). We found a statistical significant difference between the two groups in the extensor muscles power, while we did not find any statistical significant difference in flexor muscles power. The manual maximum KT-1000 arthrometer side-to-side difference was 1.7±1.7 mm for the PT group and 1.9±1.6 mm for the STG group (P=0.398). No significant correlation was found between the knee objective stability (KT-1000 measurements) and the isokinetic thigh muscle strength (extensors, Spearman’s rho=0.057, P=0.671; flexors, Spearman’s rho=0.094, P=0.489).
Conclusions: At 6 months after surgery, we found significantly lower average isokinetic quadriceps peak torque in the PT group compared to the STG group at angular velocity of 60°/s. However, at the same time we did not find significant difference in flexor muscle power comparing both groups. We did not find significant differences in knee laxity measurements between the two study groups. No significant correlation was found between the knee objective stability and the isokinetic thigh muscle strength.
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