Morphologic Characteristics and Strength of the Hamstring Muscles Remain Altered at 2 Years After Use of a Hamstring Tendon Graft in Anterior Cruciate Ligament Reconstruction

Konrath, Jason M.; Vertullo, Christopher J.; Kennedy, Ben; Bush, Hamish; Barrett, Rod; Lloyd, David G.

doi:10.1177/0363546516651441

Cited by 120 publications

(214 citation statements)

References 30 publications

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“…The surgeon then prepares the knee and drills holes in the tibia and the femur to place the graft. Several studies have shown that hamstring grafts, involving the surgical removal of the distal ST tendon are associated with significant muscle atrophy and retraction of the muscle belly (Burks et al, 2005;Konrath et al, 2016;Nomura et al, 2015).…”

Section: Hamstring Graftsmentioning

confidence: 99%

“…A number of observational studies (Konrath et al, 2016;Nomura et al, 2015;Takeda, Kashiwaguchi, Matsuura, Higashida, & Minato, 2006) have reported decrements in concentric (Tengman et al, 2014) and eccentric (Tengman et al, 2014;Thomas, Villwock, Wojtys, & PalmieriSmith, 2013) knee flexor strength in the years following ACLR surgery in addition to reduced ST muscle size (Nomura et al, 2015) and altered BFLongHead muscle architecture (Timmins, Shield, Williams, Lorenzen, & Opar, 2015). It has been suggested that after a significant knee injury, such as an ACL injury, the biomechanics of the lower limb are altered, and these changes increase the risk of future HSI (Verrall et al, 2001).…”

Section: Introductionmentioning

confidence: 99%

“…In elite sport, ACL reconstructions are almost always considered essential for restoring adequate knee joint stability (Ardern et al, 2011a;Liow, McNicholas, Keating, & Nutton, 2003), and they usually involve one of two autogenous grafts harvested from either the ipsilateral ST and gracilis or the patellar tendon (Ardern et al, 2010;Paterno et al, 2010;Pinczewski et al, 2007). Both techniques have significant long-term effects on knee muscle strength (Konrath et al, 2016;Makihara, Nishino, Fukubayashi, & Kanamori, 2006), proprioception (Katayama et al, 2004) and coordination (Yosmaoglu, Baltaci, Kaya, Ozer, & Atay, 2011) which may increase the prospects of injury recurrence and contribute to an elevated risk of HSI.…”

Section: Introductionmentioning

confidence: 99%

“…A number of observational studies (Konrath et al, 2016;Nomura et al, 2015;Takeda et al, 2006) have reported decrements in concentric (Tengman et al, 2014) and eccentric (Tengman et al, 2014;Thomas et al, 2013) knee flexor strength in the years following surgery as well as reduced muscle size (Nomura et al, 2015) and altered muscle architecture of the ST (Timmins et al, 2015). However, these studies are almost always constrained by small sample sizes, and several investigations have found conflicting results regarding the recovery of strength after rehabilitation (Aglietti et al, 1994;Ejerhed et al, 2003).…”

Section: Introductionmentioning

confidence: 99%

“…ACL injuries are immediately debilitating and can lead to chronic deficits in medial hamstring volumes (Konrath et al, 2016;Nomura, Kuramochi, & Fukubayashi, 2015;Snow, Wilcox, Burks, & Greis, 2012), knee flexor (Konrath et al, 2016;Nomura et al, 2015;Snow et al, 2012) and medial rotator strength (Konrath et al, 2016), knee stability (Abourezk et al, 2017), altered gait (Abourezk et al, 2017;Tashman, Collon, Anderson, Kolowich, & Anderst, 2004) and early onset knee osteoarthritis (Beynnon, Johnson, Abate, Fleming, & Nichols, 2005). Following ACL injury, ACL reconstruction (ACLR) surgery is widely considered to be required in sports involving rapid jumping and pivoting.…”

mentioning

confidence: 99%

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ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION & THE HAMSTRINGS Implications for injury prevention & rehabilitation

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Section: Hamstring Graftsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

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ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION & THE HAMSTRINGS Implications for injury prevention & rehabilitation

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Gait mechanics and second ACL rupture: Implications for delaying return-to-sport

et al. 2016

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Second anterior cruciate ligament rupture is a common and devastating injury among young women who return to sport after ACL reconstruction, but it is inadequately understood. The purpose of this study was to compare gait biomechanics and return-to-sport time frames in a matched cohort of young female athletes who, after primary ACLR, returned to sport without reinjury or sustained a second ACL injury. Approximately six months after primary reconstruction, fourteen young women (age 16 ± 2 years) involved in jumping, cutting, and pivoting sports underwent motion analysis testing after physical therapy and impairment resolution. Following objective return-to-sport clearance, seven athletes sustained a second ACL rupture within 20 months of surgery (13.4 ± 4.9 months). We matched them by age, sex, and sport-level to seven athletes who returned to sports without re-injury. Data were analyzed using a previously validated, EMG-informed, patient-specific musculoskeletal model. Compared to athletes without re-injury, athletes who sustained a second ACL injury received surgery sooner (p=0.023), had post-operative impairments resolved earlier (p=0.022), reached criterion-based return-to-sport benchmarks earlier (p=0.024), had higher body mass index (p=0.039), and walked with lower peak knee flexor muscle forces bilaterally (p=0.021). Athletes who sustained a second injury also tended to walk with larger (p=0.089) and more symmetrical peak knee flexion angles and less co-contraction, all indicative of a more normal gait pattern.

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Bilateral quadriceps and hamstrings muscle volume asymmetries in healthy individuals

Kulas

Schmitz

Shultz

et al. 2017

Journal Orthopaedic Research

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Determining the magnitude of quadriceps and hamstring muscle volume asymmetries in healthy individuals is a critical first step toward interpreting asymmetries as compensatory or abnormal in pathological populations. The purpose of this study was to determine the magnitude of whole and individual muscle volume asymmetries, quantified as right-left volume differences, for the quadriceps and hamstring muscles in a young and healthy population. Twenty-one healthy individuals participated: Eleven females age = 22.6 ± 2.9 years and 10 males age = 23.2 ± 3.4 years. Whole muscle group and individual muscle volume asymmetries were quantified within the context of absolute measurement error using a 95% Limits of Agreement approach. Mean muscle asymmetries ranged from -3.0 to 6.0% for all individual and whole muscle groups. Whole muscle group 95% limits of agreements represented ±11.4% and ±8.8% volume asymmetries for the hamstrings and quadriceps, respectively. Individual muscle asymmetry 95% limits of agreements ranged from ∼ ± 11-13% for the vastii muscles while the biceps femoris short-head (±33.5%), long-head (±20.9%), and the rectus femoris (±21.4%) displayed the highest relative individual asymmetries. Individual muscle asymmetries exceeded absolute measurement error in 70% of all cases, with 26% of all cases exceeding 10% asymmetry. Although whole muscle group asymmetries appear to be near the 10% assumed clinical threshold of normality, the greater magnitude of individual muscle asymmetries highlights the subject- and muscle-specific variability in volume asymmetry. Future research is warranted to determine if volume asymmetry thresholds exist that discriminate between healthy and pathological populations. Statement of Clinical Significance: Muscle volume asymmetries displayed in healthy individuals provide a reference for interpreting asymmetries in pathological populations. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 36:963-970, 2018.

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Morphologic Characteristics and Strength of the Hamstring Muscles Remain Altered at 2 Years After Use of a Hamstring Tendon Graft in Anterior Cruciate Ligament Reconstruction

Cited by 120 publications

References 30 publications

ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION & THE HAMSTRINGS Implications for injury prevention & rehabilitation

ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION & THE HAMSTRINGS Implications for injury prevention & rehabilitation

Gait mechanics and second ACL rupture: Implications for delaying return-to-sport

Bilateral quadriceps and hamstrings muscle volume asymmetries in healthy individuals

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