Weaker Quadriceps Muscle Strength With a Quadriceps Tendon Graft Compared With a Patellar or Hamstring Tendon Graft at 7 Months After Anterior Cruciate Ligament Reconstruction.
Am J Sports Med
; 52(1): 69-76, 2024 01.
Article
en En
| MEDLINE
| ID: mdl-38164665
ABSTRACT
BACKGROUND:
Impaired quadriceps muscle strength after anterior cruciate ligament reconstruction (ACLR) is associated with worse clinical outcomes and a risk of reinjuries. Yet, we know little about quadriceps muscle strength in patients reconstructed with a quadriceps tendon (QT) graft, which is increasing in popularity worldwide.PURPOSE:
To describe and compare isokinetic quadriceps strength in patients undergoing ACLR with a QT, hamstring tendon (HT), or bone-patellar tendon-bone (BPTB) autograft. STUDYDESIGN:
Cross-sectional study; Level of evidence, 3.METHODS:
We included patients with QT grafts (n = 104) and matched them to patients with HT (n = 104) and BPTB (n = 104) grafts based on age, sex, and associated meniscal surgery. Data were collected through clinical strength testing at a mean of 7 ± 1 months postoperatively. Isokinetic strength was measured at 90 deg/s, and quadriceps strength was expressed as the limb symmetry index (LSI) for peak torque, total work, torque at 30° of knee flexion, and time to peak torque.RESULTS:
Patients with QT grafts had the most impaired isokinetic quadriceps strength, with the LSI ranging between 67.5% and 75.1%, followed by those with BPTB grafts (74.4%-81.5%) and HT grafts (84.0%-89.0%). Patients with QT grafts had a significantly lower LSI for all variables compared with patients with HT grafts (mean difference peak torque -17.4% [95% CI, -21.7 to -13.2], P < .001; total work -15.9% [95% CI, -20.6 to -11.1], P < .001; torque at 30° of knee flexion -8.8% [95% CI, -14.7 to -2.9], P = .001; time to peak torque -17.7% [95% CI, -25.8 to -9.6], P < .001). Compared with patients with BPTB grafts, patients with QT grafts had a significantly lower LSI for all variables (mean difference peak torque -6.9% [95% CI, -11.2 to -2.7], P < .001; total work -7.7% [95% CI, -12.4 to -2.9], P < .001; torque at 30° of knee flexion -6.3% [95% CI, -12.2 to -0.5], P = .03; time to peak torque -8.8% [95% CI, -16.9 to -0.7], P = .03). None of the graft groups reached a mean LSI of >90% for peak torque (QT 67.5% [95% CI, 64.8-70.1]; HT 84.9% [95% CI, 82.4-87.4]; BPTB 74.4% [95% CI, 72.0-76.9]).CONCLUSION:
At 7 months after ACLR, patients with QT grafts had significantly worse isokinetic quadriceps strength than patients with HT and BPTB grafts. None of the 3 graft groups reached a mean LSI of >90% in quadriceps strength.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Ligamento Rotuliano
/
Reconstrucción del Ligamento Cruzado Anterior
/
Tendones Isquiotibiales
/
Lesiones del Ligamento Cruzado Anterior
Tipo de estudio:
Observational_studies
/
Prevalence_studies
/
Risk_factors_studies
Límite:
Humans
Idioma:
En
Revista:
Am J Sports Med
Año:
2024
Tipo del documento:
Article
País de afiliación:
Suecia
Pais de publicación:
Estados Unidos