Joint laxity and isokinetic thigh muscle strength characteristics after anterior cruciate ligament reconstruction: bone patellar tendon bone versus quadrupled hamstring autografts

Abstract

Objectives: To analyze ligamentous stability and isokinetic strength of knee extensor and flexor muscles after anterior cruciate ligament reconstruction using 2 different autografts with identical fixation.

Design: This study implements a comparative case series design.

Setting: Schulthess Clinic, Switzerland.

Patients: A total of 153 consecutive patients (n = 87 bone-patellar tendon-bone [BPTB]/66 quadruple semitendinosus/gracilis tendons [QSGT] patients) who underwent BPTB and QSGT surgery were functionally assessed.

Intervention: All patients were functionally assessed (knee extension/flexion isokinetic strength and knee joint laxity) at a mean follow-up time of 11 months.

Main outcome measurements: Laxity was measured utilizing the Kneelax arthrometer, whereas isokinetic strength of the knee extensor/flexor muscle groups was measured using the Biodex Multi Joint System 2 (180 degrees/s and 300 degrees/s).

Results: The QSGT group had significantly greater knee joint laxity when compared with the BPTB group (P < 0.001). Furthermore, females in the QSGT group demonstrated the greatest knee joint laxity overall (P < 0.001). Additionally, a significant flexor torque deficiency was demonstrated in the QSGT group (P < 0.001); however, no differences in extensor torque were observed.

Conclusions: The use of a BPTB autograft achieved better knee joint stability as well as greater knee flexor torque than the QSGT autograft. Both grafts exhibited a similar knee extensor torque deficit, indicating that only quadriceps strength is not graft-dependent.