Establishing Normal Variances and Expectations for Quadriceps Limb Symmetry Index Benchmarks Based on Time from Surgery After Anterior Cruciate Ligament Reconstruction.
Sean Hazzard, Saoirse Connolly, Ashley Wiater and 4 others
PMID 38576827WHAT IT FOUND
After autograft ACL reconstruction, estimated quadriceps strength benchmarks came later than after allograft, and the male-female difference was not clear.
Use graft-specific timelines for counseling, not fixed calendar expectations.
Key findings
01Patients with BTB autograft were estimated to reach 80% quadriceps symmetry at 7.1 months on average for females and 5.7 months on average for males.
02Patients with BTB allograft were estimated to reach 80% quadriceps symmetry at 5.4 months on average for females and 3.9 months on average for males.
03Autograft patients under 25 were estimated to reach 80% quadriceps symmetry at 6.96 months for females and 5.44 months for males.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
Only a small number of allograft patients were studied, and only 13 male allograft patients were included, so those estimates may not represent larger populations. Only three of 46 allograft patients passed the functional movement assessment, and it is unclear whether they stopped therapy before passing or could not pass. Surgeries were performed by various surgeons, and surgical technique other than graft type was unknown. Testing start time varied by patient comfort and ability, usually beginning 8 to 12 weeks after surgery. Age was used as a proxy for athletic status, which may misrepresent the larger population. Pre-surgical quadriceps strength was not used to separate patients, so outliers in baseline strength could affect the estimates.
The easy way to misread this
Do not read these estimated timelines as proof that allografts cause faster recovery or that any patient will reach a milestone on schedule. The study observed patients who had different grafts, surgical technique other than graft type was unknown, and only a few allograft patients passed functional testing.