{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,4]],"date-time":"2026-10-04T04:25:02Z","timestamp":1791087902255,"version":"4.1.0"},"reference-count":48,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2007,1,12]],"date-time":"2007-01-12T00:00:00Z","timestamp":1168560000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Knee surg. sports traumatol. arthrosc."],"published-print":{"date-parts":[[2007,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    The purpose of the present investigation was to evaluate physical outcome after anterior cruciate ligament (ACL) reconstruction with early versus late initiation of open kinetic chain (OKC) exercises for the quadriceps in patients operated on either patellar tendon or hamstring grafts. Sixty\u2010eight patients, 36\u00a0males and 32 females, with either patellar tendon graft (34 patients) or hamstring graft (34 patients) were enrolled in this study. All patients were randomly allocated to either early (the 4th postoperative week) or late (the 12th postoperative week) start of OKC exercises for the quadriceps, resulting in four subgroups: patellar tendon reconstruction, early start (P4) or late start (P12) of OKC quadriceps exercises, hamstring tendon reconstruction, early start (H4) or late start (H12) of quadriceps OKC exercises. Prior to surgery and 3, 5 and 7\u00a0months later, assessments of range of motion (goniometer), anterior knee laxity (KT\u20101000), postural sway (KAT 2000), thigh muscle torques (Kin\u2013Com dynamometer) and anterior knee pain (anterior knee pain score) were evaluated. No significant group differences were found in terms of range of motion 3, 5 and 7\u00a0months postoperatively. The H4\u00a0group showed a significantly higher mean difference of laxity over time of 1.0\u00a0mm (CI: 0.18\u20131.86) than the P4\u00a0group (\n                    <jats:italic>P<\/jats:italic>\n                    = 0.04). Within the same type of surgery, the H4 against the H12, the mean difference over time was 1.2\u00a0mm (0.37\u20132.1) higher in the H4\u00a0group than in the H12\u00a0group (\n                    <jats:italic>P<\/jats:italic>\n                    = 0.01). There were no significant group differences in terms of postural sway or anterior knee pain at the different test occasions. Significant differences in trends (changes over time) were found when comparing the four groups, for both quadriceps muscle torques (\n                    <jats:italic>P<\/jats:italic>\n                    &lt; 0.001) and hamstring muscle torques (\n                    <jats:italic>P<\/jats:italic>\n                    &lt; 0.001). All groups, except the P4\u00a0group, reached preoperative values of quadriceps muscle torques at the 7\u00a0months follow\u2010up. In the H4 and the H12\u00a0groups, significantly lower hamstring muscle torques at the 7\u00a0months follow\u2010up compared with preoperative values were found. In conclusion, early start of OKC quadriceps exercises after hamstring ACL reconstruction resulted in significantly increased anterior knee laxity in comparison with both late start and with early and late start after bone\u2013patellar tendon\u2013bone ACL reconstruction. Furthermore, the early introduction of OKC exercises for quadriceps did not influence quadriceps muscle torques neither in patients operated on patellar tendon nor hamstring tendon grafts. On the contrary, it appears as if the choice of graft affected the strength of the specific muscle more than the type of exercises performed. Our results could not determine the appropriate time for starting OKC quadriceps exercises for patients who have undergone ACL reconstruction with hamstring tendon graft. Future studies of long\u2010term results of anterior knee laxity and functional outcome are needed.\n                  <\/jats:p>","DOI":"10.1007\/s00167-006-0246-z","type":"journal-article","created":{"date-parts":[[2007,1,11]],"date-time":"2007-01-11T15:03:28Z","timestamp":1168527808000},"page":"402-414","source":"Crossref","is-referenced-by-count":74,"title":["Early versus late start of open kinetic chain quadriceps exercises after ACL reconstruction with patellar tendon or hamstring grafts: a prospective randomized outcome study"],"prefix":"10.1002","volume":"15","author":[{"given":"Annette","family":"Heijne","sequence":"first","affiliation":[{"name":"Section of Orthopaedics and Sports Medicine Department of Molecular Medicine and Surgery Karolinska Institutet 171 76 Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suzanne","family":"Werner","sequence":"additional","affiliation":[{"name":"Section of Orthopaedics and Sports Medicine Department of Molecular Medicine and Surgery Karolinska Institutet 171 76 Stockholm Sweden"},{"name":"Capio Artro Clinic Stockholm Sports Trauma Research Center Karolinska Institutet Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2007,1,12]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-200410000-00004"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1177\/03635465010290030201"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1034\/j.1600\u20100838.2000.010003164.x"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600\u20100838.2005.00446.x"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1177\/03635465010290060901"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1177\/036354658901700101"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1177\/0363546504268406"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0736\u20100266(01)00050\u2010X"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1177\/036354659502300405"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1177\/03635465990270040701"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1177\/036354658501300607"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1177\/03635465030310011401"},{"key":"e_1_2_7_14_1","first-page":"171","article-title":"Lower extremity goniometric measurements: a study to determine their reliability","volume":"63","author":"Ekstrand J","year":"1982","journal-title":"Arch Phys Med Rehabil"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1302\/0301\u2010620X.83B3.11685"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1249\/00005768-198602000-00009"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1177\/03635465030310041501"},{"key":"e_1_2_7_18_1","first-page":"131","volume-title":"Designing resistance training programs","author":"Fleck SJ","year":"1997"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1177\/03635465030310051101"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2005.04.107"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1748\u20101716.1983.tb07346.x"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1007\/s001670050211"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2004.04.069"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF01560215"},{"key":"e_1_2_7_25_1","first-page":"351","article-title":"Current state of evaluation of knee ligament lesions. 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