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I N T R O D U C T I O N : T h e study considered two presently most commonly applied reconstruction techniques using grafts of either muscles semitendinosus and gracillis (STG) or medial third of the patellar ligament (PAT). The aim of the research was to establish whether there are any qualitative neuromuscular changes and departures from healthy movement pattern shown in the surface electromyographic signal and to what extend such changes and deviations differ in terms of the applied surgery technique two years after ACL reconstruction. The results of this research could be useful in the alpine ski training because it is well known that the knees in this sport are the most loaded and prone to injury.
METHOD: The subjects were divided into three homogenous groups. The first group (P, n=10) consisted of injured athletes who were treated by PAT technique. The second group (S, n=10) comprised injured athletes treated by STG technique. The third group, control group included fully healthy athletes (C, n=10). Signal sample are measured original surface electromyographic signals of the four dominant knee muscles (m. rectus femoris, m. vastus medialis, m. vastus lateralis and m. biceps femoris) measured whilst executing the motor task of single leg vertical jump. The following variables were defined for the description of obtained signal envelopes: the initial moment of muscle activation (tstart), the moment of the end of muscle activation (tend), the moment when the maximum amplitude of electromyographic signal is reached (tmax) and duration of activation expressed in the percentage of the duration of the observed jump section (tdur).
RESULTS and DISCUSSION: The values of Kruskal-Wallis (.0166, p=.05) and Mann-Whitney (.015152, p=.05/3=.016) tests indicate a statistically significant delay of the maximum amplitude in the S group. In the flight phase the same group is reaching the maximum amplitude significantly sooner. Also, the values of Kruskal-Wallis (.0433, p=.05) and Mann-Whitney (.025974, p=.05) tests indicate a statistically significantly sooner occurrence of the maximum amplitude than in the P group. Our results show the existence of particularly statistically significant differences between observed surgical techniques that led to the change of the neuromuscular pathway during simple and controlled knee movements even two years after ACL reconstruction in athletes who have returned to active training. These disturbances of muscle coordination in the knee joint could be tied to function and location from which the autotransplant is taken and not to transplant quality itself.
CONCLUSION: Results indicate neuromuscular changes as long as two years after ACL reconstruction, when the respective rehabilitation was completed and athletes resumed a full training load. This may result in an increased risk of repeated knee injury, including potential permanent consequences. This study may primarily be useful for professional alpine skiers and their coaches, who could then plan, programme and adequately adjust their training process, thereby improving knee function in the best possible way, which in turn would maintain and extend the skiers respective sports careers. In practical terms this means that we can determine the optimal load level, at the ski slope or in the gym, which could result with positive changes in the skiers neuromuscular system without risk of injury.
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