Quadriceps strength, patellar tendon quality, relative load exposure, and knee symptoms in male athletes before the anterior cruciate ligament reconstruction.
Carla S Pereira, Jasenko Klauznicer, Dustin Maree and 4 others
PMID 37928751WHAT IT FOUND
Male athletes awaiting ACL surgery had significant quadriceps weakness and knee pain, but their patellar tendon quality was identical to the healthy leg.
Clinicians should not assume the injured tendon has degraded structurally, as the uninjured side is a valid reference for recovery.
Key findings
01Quadriceps strength in the injured leg was significantly lower than in the uninjured leg, with an average deficit of 21.7%.
02There was no significant difference in patellar tendon volume or echo-type distribution between the injured and uninjured legs.
03Knee pain, extension deficits, and perceived instability were associated with lower quadriceps strength, but not with tendon quality measures.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The study included only male athletes aged 18 to 45, so results may not apply to female athletes or older populations. Participants were at varying stages of preoperative rehabilitation, which may have influenced tendon and strength metrics. The study did not control for associated knee injuries or the amount of joint swelling, which can affect strength and pain. Ultrasound analysis used a specific software setting ('window 17'), and different settings might yield different results.
Declared interests
The authors declare no conflicts of interest. Open Access funding was provided by the Qatar National Library.
The easy way to misread this
Do not interpret the lack of tendon quality differences as evidence that the tendon is unaffected by the injury. The study shows the tendon structure is similar to the healthy side, but it does not prove the tendon is fully functional or immune to future degeneration. The primary finding is that preoperative offloading did not cause measurable structural degradation in this group.