Comparison of Muscle Strength and Functional Status of Patients with Operated and Non-Operated Chronic Total Anterior Cruciate Ligament Injury

Purpose: The study aims to compare young and active patients diagnosed with total ACL injury, with and without surgery, in terms of pain, knee functional results, quality of life, quadriceps and hamstring muscle strength, and thickness differences with ultrasonography in the chronic period. Methods: Male patients aged 18 to 40 with total ACL rupture, with or without surgery, 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-step jump, 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 ACL 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.