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Knee Surg Sports Traumatol Arthrosc. 2017 May;25(5):1449-1453. doi: 10.1007/s00167-016-4124-z. Epub 2016 Apr 7.

The evaluation of muscle recovery after anatomical single-bundle ACL reconstruction using a quadriceps autograft.

Author information

1
Department of Orthopaedic Surgery, Kamimoku Hot Springs Hospital, Minakami, Japan. sekaiwoseisu@yahoo.co.jp.
2
Department of Orthopaedic Surgery, Nihon University Hospital, Tokyo, Japan.
3
Department of Orthopaedic Surgery, Kamimoku Hot Springs Hospital, Minakami, Japan.
4
Departments of Functional Morphology, Nihon University School of Medicine, Tokyo, Japan.
5
Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburg, PA, USA.

Abstract

PURPOSE:

The purpose of this study was to reveal the degree of muscle recovery and report the clinical results of anatomical single-bundle ACL reconstruction using a quadriceps autograft.

METHODS:

Twenty subjects undergoing anatomical single-bundle ACL reconstruction using a quadriceps autograft were included in this study. A 5-mm-wide, 8-cm-long graft, involving the entire layer of the quadriceps tendon, was harvested without bone block. The average graft diameter was 8.1 ± 1.4 mm. An initial tension of 30 N was applied. The femoral tunnel was created from the far-medial portal. Each femoral and tibial tunnel was created close to the antero-medial bundle insertion site. For the evaluation of muscle recovery (quadriceps and hamstring), a handheld dynamometer was used. The evaluation of muscle recovery was performed pre-operatively, and at 3, 6, 9, and 12 months after surgery. Muscle recovery data were calculated as a percentage of leg strength in the non-operated leg. Anterior tibial translation (ATT), pivot shift test, and IKDC score were evaluated.

RESULTS:

The average quadriceps strength pre-operatively, and at 3, 6, 9, and 12 months after ACL reconstruction was 90.5 ± 19, 67.8 ± 21.4, 84 ± 17.5, and 85.1 ± 12.6 %, respectively. The average hamstring strength pre-operatively, and at 3, 6, 9, and 12 months after ACL reconstruction was 99.5 ± 13.7, 78.7 ± 11.4, 90.5 ± 19, and 96.7 ± 13.8 %, respectively. ATT pre-operatively and at 12 months after surgery was 5.4 ± 1.3 and 1.0 ± 0.8 mm, respectively. No subjects exhibited positive pivot shift after surgery. Within 6 months following surgery, quadriceps hypotrophy was observed in all subjects. However, the hypotrophy had recovered at 12 months following surgery. No subjects complained of donor site pain after surgery.

CONCLUSION:

Anatomical single-bundle ACL reconstruction using a quadriceps autograft resulted in equivalent level of muscle recovery and knee stability when compared with previously reported ACL reconstruction using hamstrings tendon with no donor site complications.

LEVEL OF EVIDENCE:

Case controlled study, Level III.

KEYWORDS:

Anatomical; Anterior cruciate ligament; Muscle recovery; Quadriceps tendon

PMID:
27056694
DOI:
10.1007/s00167-016-4124-z
[Indexed for MEDLINE]

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