Turkish Journal of Physical Medicine and Rehabilitation 2013 , Vol 59 , Num 2

The Effect of Anterior Knee Pain on Strength, Functional Tests, Proprioception and Balance After Anterior Cruciate Ligament Reconstructio

Selmin Gülbahar 1 ,Berrin Akgün 1 ,Seide Karasel 1 ,Meltem Baydar 2 ,Özlem El 1 ,Halit Pınar 3 ,Hasan Tatari 3 ,Osman Karaoğlan 3 ,Elif Akalın 1
1 Dokuz Eylül Üniversitesi Tıp Fakültesi, Fiziksel Tıp ve Rehabilitasyon Anabilim Dalı, İzmir, Türkiye
2 Clinic of Physical Medicine and Rehabilitation, Clinic a Medical Center, Samsun, Turkey
3 Dokuz Eylül Üniversitesi Tıp Fakültesi, Ortopedi ve Travmatoloji Anabilim Dalı, İzmir, Türkiye
DOI : 10.4274/tftr.32704

Objective: The aim of this study was to evaluate the effect of anterior knee pain on clinical outcome, activity level, strength, functional tests, proprioception, and balance in patients who had anterior cruciate ligament (ACL) reconstruction with a patellar tendon (PT) autograft.


Materials and Methods: Thirty-eight patients with a mean age of 27,6, who had undergone ACL reconstruction with a PT autograft and followed with a modified accelerated rehabilitation program, were included in the study. Isokinetic muscle strength of knee extension and flexion were measured using a Cybex® isokinetic dynamometer. Sport-KAT® device was used to assess the static balance. For proprioceptive assessment, an isokinetic dynamometer was used. Active repositioning was measured at knee flexions of 40°, 20°, and 5°. Activity level of the patients was assessed with Tegner activity scale and subjective functional results were evaluated using the Lysholm knee score. Single leg hop, triple leg hop, and one-legged crossover hop tests were used for objective functional testing. Anterior knee pain was evaluated with a 1-10 centimeters visual analog scale.  


Results: Fifteen patients (39.5%) had anterior knee pain. Lysholm and Tegner scores were significantly lower in patients with anterior knee pain (p<0.05). There were no significant differences in isokinetic muscle strength, functional tests, and proprioception and balance measurements between patients with and without anterior knee pain (p>0.05). For all parameters, power analysis was conducted.


Conclusion: Anterior knee pain after ACL reconstruction with PT autograft affects the patients’ Lysholm and Tegner activity scores whereas it has no effect on muscle strength, functional tests, proprioception and balance.

Keywords : Anterior cruciate ligament, reconstruction, anterior knee pain, patellofemoral pain, patellar tendon autograft