A comparative analysis of autograft choices of anterior cruciate ligament reconstruction and their effects on muscle strength and joint biomechanics
IntroductionAnterior cruciate ligament reconstruction (ACLR) is crucial to restore knee stability and function after ACL injuries, especially in physically active individuals. Despite advances in surgical techniques and rehabilitation protocols, the choice of autograft has a significant impact on po...
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Frontiers Media S.A.
2025-01-01
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| author | Wiem Issaoui Wiem Issaoui Ismail Dergaa Ismail Dergaa Ismail Dergaa Hatem Ghouili Abdelfatteh El Omri Noomen Guelmami Philippe Chomier Mourad Ghrairi Helmi Ben Saad Helmi Ben Saad Helmi Ben Saad Wassim Moalla Wassim Moalla |
| author_facet | Wiem Issaoui Wiem Issaoui Ismail Dergaa Ismail Dergaa Ismail Dergaa Hatem Ghouili Abdelfatteh El Omri Noomen Guelmami Philippe Chomier Mourad Ghrairi Helmi Ben Saad Helmi Ben Saad Helmi Ben Saad Wassim Moalla Wassim Moalla |
| author_sort | Wiem Issaoui |
| collection | DOAJ |
| description | IntroductionAnterior cruciate ligament reconstruction (ACLR) is crucial to restore knee stability and function after ACL injuries, especially in physically active individuals. Despite advances in surgical techniques and rehabilitation protocols, the choice of autograft has a significant impact on postoperative recovery, particularly on muscle strength and joint biomechanics. In this study, the effects of four autografts are investigated: Iliotibial band (ITB), combined ITB and hamstring tendon (ITB + HT), hamstring tendon (HT) and bone-tendon-bone (BTB) on quadriceps and hamstring peak torque (QPT and HPT) recovery and hamstring to quadriceps ratio (H:Q) to assess knee stability and function.MethodsForty-two active males (mean ± standard deviation of age: 31.5 ± 6.1 years, height: 177 ± 6 cm, weight: 76 ± 11 kg, body mass index: 24.5 ± 2.2 kg/m²) with primary ACL ruptures were allocated to the four graft groups (ITB: n = 16, ITB + HT: n = 12, HT: n = 7, BTB: n = 7) and underwent a standardized rehabilitation protocol. Quadriceps and hamstring peak torque (QPT and HPT, respectively) as indicators of isokinetic muscle strength were assessed both postoperatively and follow-up after approximately six months (mean 6.29 ± 1.70 months)ResultsSignificant differences in QPT and HPT recovery between the healthy and injured legs were found in all graft groups (P < 0.001). The BTB group showed the largest QPT deficit between healthy and injured legs (Δ = 133.4 Nm, Cohen's d = 8.05) and HPT deficit (Δ = 41.1 Nm, Cohen's d = 4.01). In contrast, the ITB + HT group showed the smallest deficits in QPT (Δ = 22.5 Nm, Cohen's d = 0.73) and HPT (Δ = 13.5 Nm, Cohen's d = 1.21). The BTB group also showed the largest deviation in H:Q ratios (Δ = −0.23, Cohen's d = 2.70), while the HT group showed a more balanced recovery with smaller significant deficits in H:Q ratios (Δ = −0.07, Cohen's d = 0.46).ConclusionThe BTB graft showed the most pronounced variations in QPT and HPT between healthy and injured legs in the short term, indicating the importance of longitudinally monitoring knee stability to determine the best autograft choice for ACLR. While all graft types contribute to muscle strength recovery, the HT graft may provide advantages in balancing muscle strength and potentially enhancing knee stability. |
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| institution | Kabale University |
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| series | Frontiers in Sports and Active Living |
| spelling | doaj-art-af5361a649be4f409ca7964a8fb9cead2025-01-27T14:31:26ZengFrontiers Media S.A.Frontiers in Sports and Active Living2624-93672025-01-01610.3389/fspor.2024.14444651444465A comparative analysis of autograft choices of anterior cruciate ligament reconstruction and their effects on muscle strength and joint biomechanicsWiem Issaoui0Wiem Issaoui1Ismail Dergaa2Ismail Dergaa3Ismail Dergaa4Hatem Ghouili5Abdelfatteh El Omri6Noomen Guelmami7Philippe Chomier8Mourad Ghrairi9Helmi Ben Saad10Helmi Ben Saad11Helmi Ben Saad12Wassim Moalla13Wassim Moalla14High Institute of Sport and Physical Education, University of Sfax, Sfax, TunisiaHealth Medical Services (HMS) FIFA Medical Centre of Excellence Dubai, Dubai, United Arab, EmiratesResearch Unit “Sport Sciences, Health and Movement”, Higher Institute of Sports and Physical Education of Kef, University of Jendouba, El Kef, TunisiaDepartment of Preventative Health, Primary Health Care Corporation (PHCC), Doha, QatarDepartement of Biological Sciences, High Institute of Sport and Physical Education Ksar Saïd, University of Manouba, Manouba, TunisiaResearch Unit “Sport Sciences, Health and Movement”, Higher Institute of Sports and Physical Education of Kef, University of Jendouba, El Kef, TunisiaClinical Advancement Department, Hamad Medical Corporation, Doha, QatarResearch Unit “Sport Sciences, Health and Movement”, Higher Institute of Sports and Physical Education of Kef, University of Jendouba, El Kef, TunisiaHealth Medical Services (HMS) FIFA Medical Centre of Excellence Dubai, Dubai, United Arab, EmiratesHealth Medical Services (HMS) FIFA Medical Centre of Excellence Dubai, Dubai, United Arab, EmiratesService of Physiology and Functional Explorations, Farhat Hached Hospital, University of Sousse, Sousse, TunisiaResearch Laboratory LR12SP09 “Heart Failure”, Farhat Hached Hospital, University of Sousse, Sousse, TunisiaLaboratory of Physiology, Faculty of Medicine of Sousse, University of Sousse, Sousse, TunisiaHigh Institute of Sport and Physical Education, University of Sfax, Sfax, Tunisia0Research Laboratory Education, Motricité, Sport et Santé (EM2S) LR19JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax, TunisiaIntroductionAnterior cruciate ligament reconstruction (ACLR) is crucial to restore knee stability and function after ACL injuries, especially in physically active individuals. Despite advances in surgical techniques and rehabilitation protocols, the choice of autograft has a significant impact on postoperative recovery, particularly on muscle strength and joint biomechanics. In this study, the effects of four autografts are investigated: Iliotibial band (ITB), combined ITB and hamstring tendon (ITB + HT), hamstring tendon (HT) and bone-tendon-bone (BTB) on quadriceps and hamstring peak torque (QPT and HPT) recovery and hamstring to quadriceps ratio (H:Q) to assess knee stability and function.MethodsForty-two active males (mean ± standard deviation of age: 31.5 ± 6.1 years, height: 177 ± 6 cm, weight: 76 ± 11 kg, body mass index: 24.5 ± 2.2 kg/m²) with primary ACL ruptures were allocated to the four graft groups (ITB: n = 16, ITB + HT: n = 12, HT: n = 7, BTB: n = 7) and underwent a standardized rehabilitation protocol. Quadriceps and hamstring peak torque (QPT and HPT, respectively) as indicators of isokinetic muscle strength were assessed both postoperatively and follow-up after approximately six months (mean 6.29 ± 1.70 months)ResultsSignificant differences in QPT and HPT recovery between the healthy and injured legs were found in all graft groups (P < 0.001). The BTB group showed the largest QPT deficit between healthy and injured legs (Δ = 133.4 Nm, Cohen's d = 8.05) and HPT deficit (Δ = 41.1 Nm, Cohen's d = 4.01). In contrast, the ITB + HT group showed the smallest deficits in QPT (Δ = 22.5 Nm, Cohen's d = 0.73) and HPT (Δ = 13.5 Nm, Cohen's d = 1.21). The BTB group also showed the largest deviation in H:Q ratios (Δ = −0.23, Cohen's d = 2.70), while the HT group showed a more balanced recovery with smaller significant deficits in H:Q ratios (Δ = −0.07, Cohen's d = 0.46).ConclusionThe BTB graft showed the most pronounced variations in QPT and HPT between healthy and injured legs in the short term, indicating the importance of longitudinally monitoring knee stability to determine the best autograft choice for ACLR. While all graft types contribute to muscle strength recovery, the HT graft may provide advantages in balancing muscle strength and potentially enhancing knee stability.https://www.frontiersin.org/articles/10.3389/fspor.2024.1444465/fullACLexercise therapyfunctional performancekneeorthopedic surgerypostoperative care |
| spellingShingle | Wiem Issaoui Wiem Issaoui Ismail Dergaa Ismail Dergaa Ismail Dergaa Hatem Ghouili Abdelfatteh El Omri Noomen Guelmami Philippe Chomier Mourad Ghrairi Helmi Ben Saad Helmi Ben Saad Helmi Ben Saad Wassim Moalla Wassim Moalla A comparative analysis of autograft choices of anterior cruciate ligament reconstruction and their effects on muscle strength and joint biomechanics Frontiers in Sports and Active Living ACL exercise therapy functional performance knee orthopedic surgery postoperative care |
| title | A comparative analysis of autograft choices of anterior cruciate ligament reconstruction and their effects on muscle strength and joint biomechanics |
| title_full | A comparative analysis of autograft choices of anterior cruciate ligament reconstruction and their effects on muscle strength and joint biomechanics |
| title_fullStr | A comparative analysis of autograft choices of anterior cruciate ligament reconstruction and their effects on muscle strength and joint biomechanics |
| title_full_unstemmed | A comparative analysis of autograft choices of anterior cruciate ligament reconstruction and their effects on muscle strength and joint biomechanics |
| title_short | A comparative analysis of autograft choices of anterior cruciate ligament reconstruction and their effects on muscle strength and joint biomechanics |
| title_sort | comparative analysis of autograft choices of anterior cruciate ligament reconstruction and their effects on muscle strength and joint biomechanics |
| topic | ACL exercise therapy functional performance knee orthopedic surgery postoperative care |
| url | https://www.frontiersin.org/articles/10.3389/fspor.2024.1444465/full |
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