Background:Soft tissue quadriceps tendon (QT) autografts are increasingly popular as a
primary graft choice for anterior cruciate ligament reconstruction (ACLR),
but no study has compared superficial quadriceps activity levels and leg
extension strength for QT versus bone–patellar tendon–bone (BTB)
autografts.Hypothesis:Harvesting the central portion of the QT will alter rectus femoris (RF)
firing patterns during maximum voluntary isometric contraction.Study Design:Cohort study; Level of evidence, 3.Methods:A total of 34 patients (age range, 18-40 years) who underwent ACLR using a
BTB (n = 17) or QT (n = 17) autograft at a single institution participated
in this study. Participants, who had no neuromuscular injury or prior
surgery on either lower extremity, were at least 1 year after ACLR, and were
cleared for full activity. Postoperative rehabilitation protocols were
consistent across participants. Synchronized electromyography (EMG) and
isometric torque data were collected from participants in the seated
position with the hips flexed to 90° and the knee at 60° of flexion.
Participants were asked to extend their knees as quickly as possible and
perform maximum voluntary isometric contraction for 3 seconds. A practice
trial and 3 test trials were completed with 30-second rest intervals. Mixed
(2 graft × 2 limb) analyses of variance were used to examine differences in
average and peak torque values and RF/vastus lateralis (VL) and RF/vastus
medialis (VM) ratios. Lysholm and International Knee Documentation Committee
(IKDC) scores were compared between groups using unpaired t
tests.Results:Significantly lower values were seen for the operative compared with the
nonoperative extremity for average (P = .008; η2
= 0.201) and peak torque (P < .0001; η2 =
0.321), with no significant difference between graft types. Additionally, no
significant differences in RF/VL or RF/VM ratios between limbs or graft
types were observed.Conclusion:At 1 year after ACLR, QT and BTB autografts showed similar isometric strength
deficits, with no differences in quadriceps muscle EMG ratios seen between
the 2 graft types. The results support the use of a QT autograft for ACLR,
as its graft harvest does not adversely affect quadriceps firing patterns in
comparison with BTB graft harvest.
Background: Anterior cruciate ligament reconstruction (ACLR) using the quadriceps tendon is an increasingly popular technique. Both partial-thickness quadriceps tendon (PT-Q) and full-thickness quadriceps tendon (FT-Q) graft depths are employed. Hypothesis/Purpose: This study was designed to assess isokinetic peak torque, average power, and total work during knee extension in patients with FT-Q or PT-Q grafts for ACLR. We hypothesized that both groups would show lower isokinetic values for the operated side, with greater deficits in the FT-Q group than in the PT-Q group. Study Design: Cohort study; Level of evidence, 3. Methods: A total of 26 patients who underwent ACLR with either an FT-Q or PT-Q graft were recruited between June 2021 and November 2021. Patients underwent isokinetic knee extension testing at > 1 year after surgery. Mixed repeated-measures analysis of covariance with least square difference post hoc testing was used to determine significant differences or interactions for all variables. Results: Peak torque was significantly lower for the operated limb than the nonoperated limb in the FT-Q group (mean difference [MD] ± standard error [SE], −38.6 ± 8.3 Nċm [95% CI, −55.7 to −21.5 Nċm]; P < .001; d = 0.90) but not in the PT-Q group (MD ± SE, −7.3 ± 7.7 Nċm [95% CI, −23.2 to 8.5 Nċm]; P = .348; d = 0.20). Similarly, average power for the operated limb was lower than that for the nonoperated limb in the FT-Q group (MD ± SE, −53.6 ± 13.4 W [95% CI, −81.3 to −26.9 W]; P < .001; d = 0.88) but not in the PT-Q group (MD ± SE, –4.1 ± 12.4 W [95% CI, −29.8 to 21.5 W]; P = .742; d = 0.07), and total work was lower for the operated limb compared with the nonoperated limb in the FT-Q group (MD ± SE, −118.2 ± 27.1 J [95% CI, −174.3 to −62.2 J]; P < .001; d = 0.96) but not in the PT-Q group (MD ± SE, −18.3 ± 25.1 J [95% CI, −70.2 to 33.6 J]; P = .472; d = 0.15). Conclusion: The FT-Q group showed significant deficits in the operated limb compared with the nonoperated limb for all isokinetic variables. In contrast, no significant differences were found between the nonoperated and operated limbs for the PT-Q group.
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