Quadriceps Strength following Anterior Cruciate Ligament Reconstruction: Normative Values based on Sex, Graft Type and Meniscal Status at 3, 6 & 9 Months.
Nicole A Schwery, Michael T Kiely, Christopher M Larson and 6 others
PMID 35391858WHAT IT FOUND
Hamstring grafts showed higher quadriceps symmetry than patellar or quadriceps tendon grafts at 3, 6, and 9 months.
Men had greater relative strength than women, but symmetry was similar. Meniscal repair did not affect strength outcomes.
Key findings
01Quadriceps limb symmetry index was significantly higher in patients with hamstring tendon autografts compared to bone-patellar tendon-bone and quadriceps tendon autografts at 3, 6, and 9 months.
02Relative quadriceps strength was significantly higher in males than females at all three time points, but there were no significant differences in limb symmetry between sexes.
03Concomitant meniscal repair or meniscectomy did not result in significant differences in either limb symmetry index or relative quadriceps strength compared to isolated ACL reconstruction.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The study was a retrospective analysis of prospectively collected data, which limits control over variables. Participants were recruited from a single metropolitan area, which may introduce regional bias. Postoperative rehabilitation protocols, therapy visits, and surgical techniques were not standardized or described, as procedures were performed by 36 different surgeons. The sample size for hamstring and quadriceps tendon grafts was relatively small compared to the bone-patellar tendon-bone group. Weight-bearing status for the meniscus repair group was not accounted for in the analysis. The wide age range of participants may make it difficult to generalize findings to specific populations, such as elite young athletes.
Declared interests
No specific funding sources or author conflicts of interest are mentioned in the provided text.
The easy way to misread this
Do not assume that a high limb symmetry index indicates adequate absolute strength. Males had significantly higher relative strength than females, yet their limb symmetry scores were similar. Relying solely on symmetry percentages may mask differences in the actual force-generating capacity of the quadriceps.