Effects of Autograft Types on Muscle Strength and Functional Capacity in Patients Having Anterior Cruciate Ligament Reconstruction: A Randomized Controlled Trial

Kasper Staghøj Sinding; Torsten Grønbech Nielsen; Lars Grøndahl Hvid; Martin Lind; Ulrik Dalgas

doi:10.1007/s40279-020-01276-x

Effects of Autograft Types on Muscle Strength and Functional Capacity in Patients Having Anterior Cruciate Ligament Reconstruction: A Randomized Controlled Trial

Kasper Staghøj Sinding, Torsten Grønbech Nielsen, Lars Grøndahl Hvid, Martin Lind, Ulrik Dalgas^*

^*Corresponding author for this work

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Journal article › Research › peer-review

35 Citations (Scopus)

Abstract

Background: The effects of different autograft types for anterior cruciate ligament reconstruction (ACL-R) on muscle function are sparsely investigated in randomized controlled trials. Our aim was to investigate the effects of quadriceps tendon autograft (QTB) vs. semitendinosus-gracilis autograft (StG) on thigh muscle strength and functional capacity, and a patient-reported outcome 1 year after ACL-R, and to compare the results to healthy controls. Methods: ACL-R patients (n = 100) and matched controls (CON, n = 50) were recruited, with patients being randomly assigned to QTB (n = 50) or StG (n = 50) ACL-R. One year after ACL-R, bilateral knee extensor (KE) and flexor (KF) muscle strength (isometric, dynamic, explosive, limb symmetry index [LSI], hamstring:quadriceps ratio [HQ ratio]) were assessed by isokinetic dynamometry, along with functional capacity (single leg hop distance [SHD]) and a patient-reported outcome (International Knee Documentation Committee [IKDC] score). Results: KE muscle strength of the operated leg was lower (9–11%) in QTB vs. StG as was KE LSI, while KF muscle strength was lower (12–17%) in StG vs. QTB as was KF LSI. HQ ratios were lower in StG vs. QTB. Compared with the controls, KE and KF muscle strength were lower in StG (10–22%), while KE muscle strength only was lower in QTB (16–25%). Muscle strength in the StG, QTB, and CON groups was identical in the non-operated leg. While SHD and IKDC did not differ between StG and QTB, SHD in both StG and QTB was lower than CON. The IKDC scores improved significantly 1 year following ACL-R for both graft types. Conclusion: One year after ACL-R, muscle strength is affected by autograft type, with StG leading to impairments of KE and KF muscle strength, while QTB results in more pronounced impairments of KE only. Functional capacity and patient-reported outcome were unaffected by autograft type, with the former showing impairment compared to healthy controls. Clinical Trials Registration Number: NCT02173483.

Original language	English
Journal	Sports Medicine
Volume	50
Issue	7
Pages (from-to)	1393-1403
Number of pages	11
ISSN	0112-1642
DOIs	https://doi.org/10.1007/s40279-020-01276-x
Publication status	Published - 2020

Keywords

FOLLOW-UP
HAMSTRING TENDON
INJURY
PERFORMANCE
QUADRICEPS STRENGTH
RATIOS
REGISTRY
RELIABILITY
RETURN
TIME

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10.1007/s40279-020-01276-x

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@article{4a75e8530382421fb2ea64b4f19370df,

title = "Effects of Autograft Types on Muscle Strength and Functional Capacity in Patients Having Anterior Cruciate Ligament Reconstruction: A Randomized Controlled Trial",

abstract = "Background: The effects of different autograft types for anterior cruciate ligament reconstruction (ACL-R) on muscle function are sparsely investigated in randomized controlled trials. Our aim was to investigate the effects of quadriceps tendon autograft (QTB) vs. semitendinosus-gracilis autograft (StG) on thigh muscle strength and functional capacity, and a patient-reported outcome 1 year after ACL-R, and to compare the results to healthy controls. Methods: ACL-R patients (n = 100) and matched controls (CON, n = 50) were recruited, with patients being randomly assigned to QTB (n = 50) or StG (n = 50) ACL-R. One year after ACL-R, bilateral knee extensor (KE) and flexor (KF) muscle strength (isometric, dynamic, explosive, limb symmetry index [LSI], hamstring:quadriceps ratio [HQ ratio]) were assessed by isokinetic dynamometry, along with functional capacity (single leg hop distance [SHD]) and a patient-reported outcome (International Knee Documentation Committee [IKDC] score). Results: KE muscle strength of the operated leg was lower (9–11%) in QTB vs. StG as was KE LSI, while KF muscle strength was lower (12–17%) in StG vs. QTB as was KF LSI. HQ ratios were lower in StG vs. QTB. Compared with the controls, KE and KF muscle strength were lower in StG (10–22%), while KE muscle strength only was lower in QTB (16–25%). Muscle strength in the StG, QTB, and CON groups was identical in the non-operated leg. While SHD and IKDC did not differ between StG and QTB, SHD in both StG and QTB was lower than CON. The IKDC scores improved significantly 1 year following ACL-R for both graft types. Conclusion: One year after ACL-R, muscle strength is affected by autograft type, with StG leading to impairments of KE and KF muscle strength, while QTB results in more pronounced impairments of KE only. Functional capacity and patient-reported outcome were unaffected by autograft type, with the former showing impairment compared to healthy controls. Clinical Trials Registration Number: NCT02173483.",

keywords = "FOLLOW-UP, HAMSTRING TENDON, INJURY, PERFORMANCE, QUADRICEPS STRENGTH, RATIOS, REGISTRY, RELIABILITY, RETURN, TIME",

author = "Sinding, {Kasper Stagh{\o}j} and Nielsen, {Torsten Gr{\o}nbech} and Hvid, {Lars Gr{\o}ndahl} and Martin Lind and Ulrik Dalgas",

year = "2020",

doi = "10.1007/s40279-020-01276-x",

language = "English",

volume = "50",

pages = "1393--1403",

journal = "Sports Medicine",

issn = "0112-1642",

publisher = "Springer International Publishing",

number = "7",

}

Effects of Autograft Types on Muscle Strength and Functional Capacity in Patients Having Anterior Cruciate Ligament Reconstruction: A Randomized Controlled Trial. / Sinding, Kasper Staghøj; Nielsen, Torsten Grønbech ; Hvid, Lars Grøndahl et al.
In: Sports Medicine, Vol. 50, No. 7, 2020, p. 1393-1403.

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Journal article › Research › peer-review

TY - JOUR

T1 - Effects of Autograft Types on Muscle Strength and Functional Capacity in Patients Having Anterior Cruciate Ligament Reconstruction

T2 - A Randomized Controlled Trial

AU - Sinding, Kasper Staghøj

AU - Nielsen, Torsten Grønbech

AU - Hvid, Lars Grøndahl

AU - Lind, Martin

AU - Dalgas, Ulrik

PY - 2020

Y1 - 2020

N2 - Background: The effects of different autograft types for anterior cruciate ligament reconstruction (ACL-R) on muscle function are sparsely investigated in randomized controlled trials. Our aim was to investigate the effects of quadriceps tendon autograft (QTB) vs. semitendinosus-gracilis autograft (StG) on thigh muscle strength and functional capacity, and a patient-reported outcome 1 year after ACL-R, and to compare the results to healthy controls. Methods: ACL-R patients (n = 100) and matched controls (CON, n = 50) were recruited, with patients being randomly assigned to QTB (n = 50) or StG (n = 50) ACL-R. One year after ACL-R, bilateral knee extensor (KE) and flexor (KF) muscle strength (isometric, dynamic, explosive, limb symmetry index [LSI], hamstring:quadriceps ratio [HQ ratio]) were assessed by isokinetic dynamometry, along with functional capacity (single leg hop distance [SHD]) and a patient-reported outcome (International Knee Documentation Committee [IKDC] score). Results: KE muscle strength of the operated leg was lower (9–11%) in QTB vs. StG as was KE LSI, while KF muscle strength was lower (12–17%) in StG vs. QTB as was KF LSI. HQ ratios were lower in StG vs. QTB. Compared with the controls, KE and KF muscle strength were lower in StG (10–22%), while KE muscle strength only was lower in QTB (16–25%). Muscle strength in the StG, QTB, and CON groups was identical in the non-operated leg. While SHD and IKDC did not differ between StG and QTB, SHD in both StG and QTB was lower than CON. The IKDC scores improved significantly 1 year following ACL-R for both graft types. Conclusion: One year after ACL-R, muscle strength is affected by autograft type, with StG leading to impairments of KE and KF muscle strength, while QTB results in more pronounced impairments of KE only. Functional capacity and patient-reported outcome were unaffected by autograft type, with the former showing impairment compared to healthy controls. Clinical Trials Registration Number: NCT02173483.

AB - Background: The effects of different autograft types for anterior cruciate ligament reconstruction (ACL-R) on muscle function are sparsely investigated in randomized controlled trials. Our aim was to investigate the effects of quadriceps tendon autograft (QTB) vs. semitendinosus-gracilis autograft (StG) on thigh muscle strength and functional capacity, and a patient-reported outcome 1 year after ACL-R, and to compare the results to healthy controls. Methods: ACL-R patients (n = 100) and matched controls (CON, n = 50) were recruited, with patients being randomly assigned to QTB (n = 50) or StG (n = 50) ACL-R. One year after ACL-R, bilateral knee extensor (KE) and flexor (KF) muscle strength (isometric, dynamic, explosive, limb symmetry index [LSI], hamstring:quadriceps ratio [HQ ratio]) were assessed by isokinetic dynamometry, along with functional capacity (single leg hop distance [SHD]) and a patient-reported outcome (International Knee Documentation Committee [IKDC] score). Results: KE muscle strength of the operated leg was lower (9–11%) in QTB vs. StG as was KE LSI, while KF muscle strength was lower (12–17%) in StG vs. QTB as was KF LSI. HQ ratios were lower in StG vs. QTB. Compared with the controls, KE and KF muscle strength were lower in StG (10–22%), while KE muscle strength only was lower in QTB (16–25%). Muscle strength in the StG, QTB, and CON groups was identical in the non-operated leg. While SHD and IKDC did not differ between StG and QTB, SHD in both StG and QTB was lower than CON. The IKDC scores improved significantly 1 year following ACL-R for both graft types. Conclusion: One year after ACL-R, muscle strength is affected by autograft type, with StG leading to impairments of KE and KF muscle strength, while QTB results in more pronounced impairments of KE only. Functional capacity and patient-reported outcome were unaffected by autograft type, with the former showing impairment compared to healthy controls. Clinical Trials Registration Number: NCT02173483.

KW - FOLLOW-UP

KW - HAMSTRING TENDON

KW - INJURY

KW - PERFORMANCE

KW - QUADRICEPS STRENGTH

KW - RATIOS

KW - REGISTRY

KW - RELIABILITY

KW - RETURN

KW - TIME

UR - http://www.scopus.com/inward/record.url?scp=85081005494&partnerID=8YFLogxK

U2 - 10.1007/s40279-020-01276-x

DO - 10.1007/s40279-020-01276-x

M3 - Journal article

C2 - 32125668

AN - SCOPUS:85081005494

SN - 0112-1642

VL - 50

SP - 1393

EP - 1403

JO - Sports Medicine

JF - Sports Medicine

IS - 7

ER -

Effects of Autograft Types on Muscle Strength and Functional Capacity in Patients Having Anterior Cruciate Ligament Reconstruction: A Randomized Controlled Trial

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Keywords

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