Impact of Hamstring Graft on Hamstring Peak Torque and Maximum Effective Angle After Anterior Cruciate Ligament Reconstruction: An Exploratory and Preliminary Study

Purpose: Anterior cruciate ligament reconstruction (ACLR) using the hamstring graft is commonly performed to restore knee stability; however, it induces significant neuromuscular and biomechanical changes, particularly in the hamstring. This study aimed to evaluate the changes in maximum effective a...

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Main Authors: Ismail Bouzekraoui Alaoui, Ayrton Moiroux-Sahraoui, Jean Mazeas, Georgios Kakavas, Maciej Biały, Maurice Douryang, Florian Forelli
Format: Article
Language:English
Published: MDPI AG 2025-04-01
Series:Bioengineering
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Online Access:https://www.mdpi.com/2306-5354/12/5/465
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author Ismail Bouzekraoui Alaoui
Ayrton Moiroux-Sahraoui
Jean Mazeas
Georgios Kakavas
Maciej Biały
Maurice Douryang
Florian Forelli
author_facet Ismail Bouzekraoui Alaoui
Ayrton Moiroux-Sahraoui
Jean Mazeas
Georgios Kakavas
Maciej Biały
Maurice Douryang
Florian Forelli
author_sort Ismail Bouzekraoui Alaoui
collection DOAJ
description Purpose: Anterior cruciate ligament reconstruction (ACLR) using the hamstring graft is commonly performed to restore knee stability; however, it induces significant neuromuscular and biomechanical changes, particularly in the hamstring. This study aimed to evaluate the changes in maximum effective angle, hamstring strength, and hamstring-to-quadriceps (H/Q) strength ratio at 3 and 6 months post-ACLR and compare these outcomes to a control group. Methods: This prospective controlled study included 20 ACLR patients and 20 age- and gender-matched controls. Hamstring peak torque, maximum effective angle (MEA), and the H/Q ratio were assessed using isokinetic dynamometry at 60°/s. The ACLR group was evaluated postoperatively at 3 and 6 months, while the control group underwent a single evaluation. Results: At 3 and 6 months, the ACLR group exhibited significantly lower MEA (26.3° ± 8.2 and 28.2° ± 9.4) compared to the control group (36.4° ± 12.0; <i>p</i> < 0.01). Hamstring peak torque and H/Q ratios were also lower in the ACLR group but showed slight improvements over time. The H/Q ratio increased significantly between 3 and 6 months (51% to 56%; <i>p</i> = 0.041). Conclusion: The use of hamstring graft in ACLR leads to persistent MEA and strength deficits despite rehabilitation. Advanced, targeted rehabilitation protocols are essential to address these deficits, optimize recovery, and reduce the risk of reinjury.
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spelling doaj-art-8f9075a4d84d4f95ac04c20dd989708a2025-08-20T03:14:42ZengMDPI AGBioengineering2306-53542025-04-0112546510.3390/bioengineering12050465Impact of Hamstring Graft on Hamstring Peak Torque and Maximum Effective Angle After Anterior Cruciate Ligament Reconstruction: An Exploratory and Preliminary StudyIsmail Bouzekraoui Alaoui0Ayrton Moiroux-Sahraoui1Jean Mazeas2Georgios Kakavas3Maciej Biały4Maurice Douryang5Florian Forelli6Mohammed VI University of Sciences and Health—UM6SS, Casablanca 20270, MoroccoOrthosport Rehab Center, 95330 Domont, FranceOrthosport Rehab Center, 95330 Domont, FranceFysiotek Spine and Sports Lab, 11635 Athens, GreeceInstitute of Physiotherapy and Health Sciences, The Jerzy Kukuczka Academy of Physical Education, 40-065 Katowice, PolandDepartment of Physiotherapy and Physical Medicine, University of Dschang, Dschang P.O. Box 96, CameroonOrthopaedic Surgery Department, Clinic of Domont, Ramsay Healthcare, @OrthoLab, 95330 Domont, FrancePurpose: Anterior cruciate ligament reconstruction (ACLR) using the hamstring graft is commonly performed to restore knee stability; however, it induces significant neuromuscular and biomechanical changes, particularly in the hamstring. This study aimed to evaluate the changes in maximum effective angle, hamstring strength, and hamstring-to-quadriceps (H/Q) strength ratio at 3 and 6 months post-ACLR and compare these outcomes to a control group. Methods: This prospective controlled study included 20 ACLR patients and 20 age- and gender-matched controls. Hamstring peak torque, maximum effective angle (MEA), and the H/Q ratio were assessed using isokinetic dynamometry at 60°/s. The ACLR group was evaluated postoperatively at 3 and 6 months, while the control group underwent a single evaluation. Results: At 3 and 6 months, the ACLR group exhibited significantly lower MEA (26.3° ± 8.2 and 28.2° ± 9.4) compared to the control group (36.4° ± 12.0; <i>p</i> < 0.01). Hamstring peak torque and H/Q ratios were also lower in the ACLR group but showed slight improvements over time. The H/Q ratio increased significantly between 3 and 6 months (51% to 56%; <i>p</i> = 0.041). Conclusion: The use of hamstring graft in ACLR leads to persistent MEA and strength deficits despite rehabilitation. Advanced, targeted rehabilitation protocols are essential to address these deficits, optimize recovery, and reduce the risk of reinjury.https://www.mdpi.com/2306-5354/12/5/465anterior cruciate ligament reconstructionmaximum effective anglehamstring-to-quadriceps strength ratiohamstring strength
spellingShingle Ismail Bouzekraoui Alaoui
Ayrton Moiroux-Sahraoui
Jean Mazeas
Georgios Kakavas
Maciej Biały
Maurice Douryang
Florian Forelli
Impact of Hamstring Graft on Hamstring Peak Torque and Maximum Effective Angle After Anterior Cruciate Ligament Reconstruction: An Exploratory and Preliminary Study
Bioengineering
anterior cruciate ligament reconstruction
maximum effective angle
hamstring-to-quadriceps strength ratio
hamstring strength
title Impact of Hamstring Graft on Hamstring Peak Torque and Maximum Effective Angle After Anterior Cruciate Ligament Reconstruction: An Exploratory and Preliminary Study
title_full Impact of Hamstring Graft on Hamstring Peak Torque and Maximum Effective Angle After Anterior Cruciate Ligament Reconstruction: An Exploratory and Preliminary Study
title_fullStr Impact of Hamstring Graft on Hamstring Peak Torque and Maximum Effective Angle After Anterior Cruciate Ligament Reconstruction: An Exploratory and Preliminary Study
title_full_unstemmed Impact of Hamstring Graft on Hamstring Peak Torque and Maximum Effective Angle After Anterior Cruciate Ligament Reconstruction: An Exploratory and Preliminary Study
title_short Impact of Hamstring Graft on Hamstring Peak Torque and Maximum Effective Angle After Anterior Cruciate Ligament Reconstruction: An Exploratory and Preliminary Study
title_sort impact of hamstring graft on hamstring peak torque and maximum effective angle after anterior cruciate ligament reconstruction an exploratory and preliminary study
topic anterior cruciate ligament reconstruction
maximum effective angle
hamstring-to-quadriceps strength ratio
hamstring strength
url https://www.mdpi.com/2306-5354/12/5/465
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