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This study is intended to find more effective and robust clinical diagnostic indices to characterize muscle strength and coordination alternation following anterior cruciate ligament (ACL) rupture. To evaluate angle-specific moments and hamstring (H)/quadriceps (Q) ratios, 46 male subjects with unilateral chronic ACL-rupture performed isokinetic concentric (c), eccentric (e) quadriceps and hamstring muscle tests respectively at 60°/s. Normalized moments and H/Q ratios were calculated for peak moment (PM) and 30°, 40°, 50°, 60°, 70°, 80° knee flexion angles. Furthermore, we introduced single-to-arithmetic-mean (SAM) and single-to-root-mean-square (SRMS) muscle co-contraction ratios, calculating them for specific angles and different contraction repetitions. Normalized PM and 40° specific concentric quadriceps, concentric hamstring strength in the ACL-deficient knee were reduced significantly ( P  ≤ 0.05). Concentric angle-specific moments together with Qe/Qc ratios at 40° ( d  = 0.766 vs.  d  = 0.654) identify more obvious differences than peak values in ACL ruptured limbs. Furthermore, we found SRMS-QeQc deficits at 40° showed stronger effect than Qe/Qc ratios ( d  = 0.918 vs.  d  = 0.766), albeit other ratio differences remained basically the same effect size as the original H/Q ratios. All the newly defined SAM and SRMS indices could decrease variance. Overall, 40° knee moments and SAM/SRMS ratios might be new potential diagnosis indices for ACL rupture detection.

Isokinetic angle-specific moments and ratios characterizing hamstring and quadriceps strength in anterior cruciate ligament deficient knees