{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T15:42:08Z","timestamp":1787499728880,"version":"build-2736575974"},"reference-count":48,"publisher":"National Athletic Trainers' Association","issue":"10","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018,10,1]]},"abstract":"<jats:sec>\n                    <jats:title>Context<\/jats:title>\n                    <jats:p>Relationships between quadriceps function and patient-reported outcomes after anterior cruciate ligament reconstruction (ACLR) are variable and may be confounded by including patients at widely different time points after surgery. Understanding these relationships during the clinically relevant phases of recovery may improve our knowledge of specific factors that influence clinical outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To identify the relationships between quadriceps function and patient-reported outcomes in patients &amp;lt;2 years (early) and &amp;gt;2 years (late) after ACLR, including those with posttraumatic knee osteoarthritis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Cross-sectional study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Laboratory.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients or Other Participants<\/jats:title>\n                    <jats:p>A total of 72 patients after ACLR: early (n = 34, time from surgery = 9.0 \u00b1 4.3 months), late (n = 30, time from surgery = 70.5 \u00b1 41.6 months), or osteoarthritis (n = 8, time from surgery = 115.9 \u00b1 110.0 months).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Outcome Measure(s)<\/jats:title>\n                    <jats:p>The total Knee Injury and Osteoarthritis Outcome Score (KOOS) and Veterans RAND 12-Item Health Survey (VR-12) were used to quantify knee function and global health. Predictors of patient-reported outcomes were involved-limb and symmetry indices of quadriceps function (isokinetic strength [peak torque, total work, average power], maximum voluntary isometric contraction torque, fatigue index, central activation ratio, Hoffmann reflex, active motor threshold) and demographics (age, activity level, pain, kinesiophobia, time since surgery). Multiple linear regression analyses were used to predict KOOS and VR-12 scores in each group.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In the early patients, knee-extensor work, active motor threshold symmetry, pain, and activity level explained 67.8% of the variance in the KOOS score (P &amp;lt; .001); knee-extensor work, activity level, and pain explained 53.0% of the variance in the VR-12 score (P &amp;lt; .001). In the late patients, age and isokinetic torque symmetry explained 28.9% of the variance in the KOOS score (P = .004). In the osteoarthritis patients, kinesiophobia and isokinetic torque explained 77.8% of the variance in the KOOS score (P = .010); activity level explained 86.4% of the variance in the VR-12 score (P = .001).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Factors of muscle function and demographics that explain patient-reported outcomes were different in patients early and late after ACLR and in those with knee osteoarthritis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4085\/1062-6050-170-17","type":"journal-article","created":{"date-parts":[[2018,10,5]],"date-time":"2018-10-05T07:48:26Z","timestamp":1538725706000},"page":"965-975","source":"Crossref","is-referenced-by-count":24,"title":["Quadriceps Function and Patient-Reported Outcomes After Anterior Cruciate Ligament Reconstruction in Patients With or Without Knee Osteoarthritis"],"prefix":"10.4085","volume":"53","author":[{"given":"Grant E.","family":"Norte","sequence":"first","affiliation":[{"name":"School of Exercise and Rehabilitation Sciences, Athletic Training Program, University of Toledo, OH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jay","family":"Hertel","sequence":"first","affiliation":[{"name":"Department of Kinesiology, Sports Medicine Program, University of Virginia, Charlottesville"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan A","family":"Saliba","sequence":"first","affiliation":[{"name":"Department of Kinesiology, Sports Medicine Program, University of Virginia, Charlottesville"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David R.","family":"Diduch","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery, University of Virginia, Charlottesville"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph M.","family":"Hart","sequence":"first","affiliation":[{"name":"Department of Kinesiology, Sports Medicine Program, University of Virginia, Charlottesville"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2557","published-online":{"date-parts":[[2018,10,5]]},"reference":[{"issue":"9","key":"2020060411152542100_i1062-6050-53-10-965-b01","doi-asserted-by":"crossref","first-page":"1512","DOI":"10.1177\/0363546506286866","article-title":"Understanding and preventing noncontact anterior cruciate ligament injuries: a review of the Hunt Valley II meeting, January 2005","volume":"34","author":"Griffin","year":"2006","journal-title":"Am J Sports Med"},{"issue":"1","key":"2020060411152542100_i1062-6050-53-10-965-b02","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1177\/0363546511422999","article-title":"Return-to-sport outcomes at 2 to 7 years after anterior cruciate ligament reconstruction surgery","volume":"40","author":"Ardern","year":"2012","journal-title":"Am J Sports Med"},{"issue":"5","key":"2020060411152542100_i1062-6050-53-10-965-b03","doi-asserted-by":"crossref","first-page":"1215","DOI":"10.1177\/0363546515626539","article-title":"Changes in knee osteoarthritis, symptoms, and function after anterior cruciate ligament reconstruction: a 20-year prospective follow-up study","volume":"44","author":"Risberg","year":"2016","journal-title":"Am J Sports Med"},{"issue":"2","key":"2020060411152542100_i1062-6050-53-10-965-b04","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1016\/j.jphys.2016.02.011","article-title":"Activity preferences, lifestyle modifications and re-injury fears influence longer-term quality of life in people with knee symptoms following anterior cruciate ligament reconstruction: a qualitative study","volume":"62","author":"Filbay","year":"2016","journal-title":"J Physiother"},{"issue":"9","key":"2020060411152542100_i1062-6050-53-10-965-b05","doi-asserted-by":"crossref","first-page":"1671","DOI":"10.1249\/MSS.0000000000000946","article-title":"Quadriceps strength predicts self-reported function post-ACL reconstruction","volume":"48","author":"Pietrosimone","year":"2016","journal-title":"Med Sci Sports Exerc"},{"issue":"2","key":"2020060411152542100_i1062-6050-53-10-965-b06","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1016\/j.joca.2014.10.008","article-title":"Knee extensor muscle weakness is a risk factor for development of knee osteoarthritis. 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