Strength recovery after anterior cruciate ligament reconstruction with quadriceps tendon versus hamstring tendon autografts in soccer players: A randomized controlled trial

• Published in: The knee 2018-08, Vol.25 (4), p.704-714
• Main Authors: Martin-Alguacil, Jose Luis, Arroyo-Morales, Manuel, Martín-Gomez, Jose Luis, Monje-Cabrera, Isidro Manuel, Abellán-Guillén, Juan F., Esparza-Ros, Francisco, Lozano, Mario Lozano, Cantarero-Villanueva, Irene
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Anterior cruciate ligament; Anterior Cruciate Ligament Injuries - physiopathology; Anterior Cruciate Ligament Injuries - surgery; Anterior Cruciate Ligament Reconstruction - methods; Autografts; Clinical trials; Female; Functional recovery; Hamstring graft; Hamstring Muscles - physiopathology; Hamstring Tendons - transplantation; Humans; Knee; Ligaments; Male; Motivation; Muscle strength; Muscle Strength - physiology; Prospective Studies; Quadriceps muscle; Quadriceps Muscle - physiopathology; Quadriceps tendon graft; Recovery (Medical); Recovery of Function - physiology; Rehabilitation; Soccer; Soccer - injuries; Strength; Studies; Surgeons; Surgery; Torque; Transplantation, Autologous; Young Adult
• ISSN: 0968-0160; 1873-5800
• DOI: 10.1016/j.knee.2018.03.011

The comparison between HT and QT grafts in strength recovery and function after an ACLR is scarce in the literature. A total of 56 participants were enrolled in this randomized controlled trial and placed into two groups: HT or QT. The hamstring/quadriceps (H/Q) ratio was the primary end-point measured with a Genu-3 dynamometer. Peak torque, functional assessment (Lysholm knee scoring scale and Cincinnati Knee Rating System), and anteroposterior laxity (KT-2000™ arthrometer) were also assessed. An intention-to-treat analysis was performed. The results of the H/Q ratio analysis of the participants over time revealed significant differences at 60, 180, and 300°/s at three, six, and 12months of follow-up (60°/s: F=5.3, p=0.005; 180°/s: F=5.5, p=0.004; 300°/s: F=5.1, p=0.005). Furthermore, they revealed significant differences at 60°/s, 180°/s, and 300°/s in the participants over time for peak torque in the extensor muscle strength at three and six months of follow-up, with higher values in the hamstring tendon group but not at 12months of follow-up. There were no significant differences in functional endpoints or arthrometer assessments at 24months of follow-up. An ACLR with a QT graft showed similar functional results with a better isokinetic H/Q ratio compared to an ACLR with the HT at 12months of follow-up in soccer players. This higher H/Q ratio observed with the QT could be an advantage of this graft over the HT for an ACLR.