Examination of Knee Isokinetic Strength and Single-Leg Balance of Operated and Non-Operated Side of Patients with Unilateral Matrix-Induced Autologous Chondrocyte Implantation (MACI) Surgery : Pilot Study

• Main Authors: Çağlar Soylu, Bihter Akınoğlu, Necmiye Ün Yıldırım, Murat Bozkurt, Tuğba Kocahan
• Format: Article
• Language: English
• Published: Turkish Sports Medicine Association 2017-09-01
• Series: Spor Hekimligi Dergisi
• Subjects: Cartilage; autologous chondrocyte implantation; muscle strength; rehabilitation
• Online Access: http://journalofsportsmedicine.org/eng/full-text/284/tur

Objective: The purpose of this study is to compare the operated- and non-operated side quadri-ceps and hamstring isokinetic muscle strength and single-leg standing balance of patients who underwent Matrix-Induced Autologous Chondrocyte Implantation (MACI) surgery followed by a home exercise program for two years. Materials and Methods: The study was performed with seven patients aged between 26-48 years (mean 37.2 ± 7.9 yrs), who had undergone unilateral MACI surgery two years ago and were followed up with a home program. Isokinetic knee flexion/extension muscle strength was evaluated bilaterally with an ISOMED 2000® (D & R Ferstl GmbH, Hemau, Germany) device at angular velocities of 60°/s and 180°/s. Single-leg balance measurements were performed with a Human Body Equilibrium 360 device (HUBER 360®). Results: There was no statistically significant differences between operated and healthy side knee flexion and extension isokinetic muscle strength (60°/s-180°s), hamstring/quadriceps ratio, and single-leg balance scores (p>0.05). Literature concensus advises that the hamstring/ quadriceps ratio should be 50-60% at 60°/s and 60-70% at 180°/s. In the present study, it was determined that this ratio was 63% and 72% respectively at 60°/s and 180°/s, and that there was a muscle force imbalance concerning the quadriceps, which was within normal limits (57%-62%) on the non-operated side. It was determined that knee extensor strength was greater in the non-operated side at both angular velocities, and this difference was more than 10%, the rate which is considered normal according to literature. Conclusion: It was determined that the operated side's hamstring/quadriceps ratio after MACI surgery was weaker than the normal value, against the quadriceps, and for quadriceps muscle strength of both sides, there was a difference higher than 10%, which is considered to be the normal limit. This reveals that home programs may be insufficient for people who have undergone MACI surgery, and also that muscular strength of people should be followed up in the long term. Therefore, we think that special rehabilitation protocols as the ones that exist in other knee cartilage operations should be applied following MACI surgery.