Isokinetic Knee Muscle Strength Following Anterior Cruciate Ligament Reconstruction in Adolescent Patients: A Comparison of In-Hospital Versus Private Clinic Rehabilitation
Bibliographic record
Abstract
Purpose: To determine if rehabilitation after anterior cruciate ligament (ACL) reconstruction (ACL-R) in a tertiary care paediatric orthopaedic centre (TPOC) yields superior outcomes compared to private clinic (PC) rehabilitation. Method: In this retrospective analysis, patients aged 13 to 18 years who underwent standardized isokinetic knee assessment 5 to 7 months after ACL-R were reviewed. Exclusion criteria: previous injury to the non-operated limb, neuromuscular musculoskeletal disorder, isolated meniscal repair, isolated meniscectomy, posterior cruciate ligament reconstruction, and medial patellofemoral ligament reconstruction. To determine which of the two rehabilitation settings had the best outcomes, isokinetic parameters and patient-reported outcomes were compared between the TPOC and the PC groups using univariate analysis of variance. Results: Among 276 patients (63% female), 34 performed rehabilitation in a PC (12%) and 242 performed their rehabilitation in a TPOC (88%). Except “ACL graft used” ( p < 0.05), no significant difference was found in demographic variables between the two rehabilitation groups. Patients who attended the TPOC setting had significantly higher limb symmetry index in flexion at 180°/s ( p = 0.04), average relative peak torque in extension at 60°/s ( p = 0.03), z-score at 60°/s in extension ( p = 0.03), and total work at 60°/s in flexion ( p = 0.04) compared to the PC group. ACL Return to Sport after Injury Scale scores were superior for PC rehabilitation patients (mean 83 [SD 20]) compared to patients attending the TPOC (mean 70 [SD 18]) ( p = 0.03). Conclusions: Patients managed in a TPOC have better isokinetic outcomes 6 to 7 months post-surgery compared to patients managed in a PC rehabilitation setting, which may suggest that the expertise and multidisciplinary nature of the TPOC favour rehabilitation.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".