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The influence of graft choice on isokinetic muscle strength 4–24 months after anterior cruciate ligament reconstruction

  • Knee
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

Regaining adequate strength of the quadriceps and hamstrings after anterior cruciate ligament (ACL) reconstruction is important for maximizing functional performance. However, the outcome of muscle strength after either BPTB or hamstrings autograft is unclear given the plethora of published studies that report post-operative muscle strength. The purpose of this study was to systematically compare the muscle strength of patients who have undergone ACL reconstruction using either Bone Patellar Tendon Bone (BPTB) or Hamstrings (HST) autograft.

Methods

The databases of MEDLINE, Cinahal and EMBASE were systematically searched for articles that report muscle strength outcome following ACL reconstruction. The quality of the studies was evaluated and a meta-analysis of the muscle strength outcomes was conducted on reported data.

Results

Fourteen studies were included in this systematic review: eight Randomized Control Studies (RCT) and six non-Randomized Control Studies (non-RCT). A meta-analysis was performed involving eight of the included studies (4 RCTs & 3 non-RCTs). At 60°/s and 180°/s, patients with BPTB graft showed a greater deficit in extensor muscle strength and lower deficit in flexor muscle strength compared with patients with HST.

Conclusion

This systematic review of Level III evidence showed that isokinetic muscle strength deficits following ACL reconstruction are associated with the location of the donor site. These deficits appear to be unresolved up to 2 years after ACL reconstruction.

Level of evidence

III.

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Acknowledgments

The authors acknowledge the support from the Greek General Secretariat for Research and Technology and the European Union (Operative Program Competitiveness; AKMON) to the Orthopaedic Sports Medicine Center, and the Hellenic Association of Orthopaedic Surgery & Traumatology.

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Authors and Affiliations

  1. Orthopaedic Sports Medicine Center of Ioannina, Department of Orthopaedic Surgery, University of Ioannina, PO BOX 1042, 45110, Ioannina, Greece

    Sofia A. Xergia, Haris S. Vasiliadis & Anastasios D. Georgoulis

  2. Musculoskeletal Research Centre, La Trobe University, Melbourne, VIC, Australia

    Jodie A. McClelland

  3. Department of Physical Therapy, University of Delaware, Newark, DE, USA

    Jodie A. McClelland

  4. Division of Physiotherapy, Department of Medical and Health Sciences, Linköping University, Linköping, Sweden

    Joanna Kvist

  5. Molecular Cell Biology and Regenerative Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden

    Haris S. Vasiliadis

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  1. Sofia A. Xergia
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  2. Jodie A. McClelland
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  3. Joanna Kvist
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  4. Haris S. Vasiliadis
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  5. Anastasios D. Georgoulis
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Corresponding author

Correspondence to Anastasios D. Georgoulis.

Appendix

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Fig. 5
figure 5

Flow chart of the search and included and excluded studies

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Xergia, S.A., McClelland, J.A., Kvist, J. et al. The influence of graft choice on isokinetic muscle strength 4–24 months after anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc 19, 768–780 (2011). https://doi.org/10.1007/s00167-010-1357-0

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