Comparison of muscle strength and functional status of patients with operated and non-operated chronic total anterior cruciate ligament injury

Background. The anterior cruciate ligament (ACL) plays a fundamental role in maintaining knee joint stability, primarily by preventing the forward translation of the tibia relative to the femur. The functional effects of ACL injuries can be seen in patients, irrespective of their surgical intervention. The aim of the study — to compare knee functional results, quality of life, quadriceps and hamstring muscle strengths, and muscle thickness differences using ultrasonography between patients diagnosed with total anterior cruciate ligament injury who have undergone surgery and those who have not. Methods. Male patients aged 18 to 40 with total ACL rupture were evaluated during chronic period. The study evaluated patients’ pain levels, joint range of motion, thigh circumference measurements using the visual analog scale, and quadriceps and hamstring muscle thickness measurements using ultrasonography. Functionality was assessed using the single-leg jump test, Lysholm Knee Scale, and Anterior Cruciate Ligament Quality of Life Questionnaire. Results. The study involved 21 non-operated and 20 operated patients. The rate of rehabilitation was significantly higher in the operated group, despite no significant difference between the groups in terms of the injured side. Furthermore, the operated group exhibited a statistically significant difference in thigh circumference between the right and left sides. The evaluation conducted by USG found a significant difference in hamstring muscle thickness between the operated group and the control group. However, there was no significant difference observed between the groups in terms of knee functionality, as indicated by the Lysholm knee scale and jump tests, and flexor and extensor isokinetic muscle strengths. Conclusion. Patients with anterior cruciate ligament injuries may exhibit no significant difference between knee functionality and isokinetic muscle strength evaluations, regardless of whether they have undergone surgery or not. However, the group that underwent surgery showed significant muscle loss.