Anterior Cruciate Ligament Reconstruction with Hamstring Tendons Has no Deleterious Effect on Hip Extension Strength

Document Type: RESEARCH PAPER

Authors

1 Arak University of Medical Sciences, Arak, Iran

2 Bone and Joint Reconstruction Research Center, Shafa Orthopedic Hospital, Iran University of Medical Sciences, Tehran, Iran

3 Bone and Joint Reconstruction Research Center, Shafa Orthopedic Hospital, Iran University of medical Scienses, Tehran, Iran

Abstract

Background: Hamstring tendons are secondary hip extensors. Their harvest for graft in anterior cruciate ligament
(ACL) reconstruction may create deleterious effect on hip extension strength. This is of particular importance in sports
that need powerful hip extension force like climbing and sprinting. Due to scarcity of a comprehensive study in this
area, we designed this prospective study to evaluate hip extension strength following ACL reconstruction using different
types of grafts.
Methods: Fifty eight patients were enrolled in this prospective non-randomized case control study to compare
isokinetic hip extension strength following ACL reconstruction with different graft types. Twenty patients in group
A (both Semitendinosus and Gracilis tendons autograft (ST-G)), 14 patients in group B (Tibialis Posterior tendon
allograft (Allograft)), 12 patients in group C (bone-patellar tendon-bone autograft (BPTB)) and 12 patients in group D
(only semitendinosus autograft (ST)) were studied. Hip extension strength was tested post-operatively at three- and
six-month periods using a Biodex isokinetic testing machine at a speed of 30 degree per second in operated (cases)
and non-operated (controls) limbs.
Results: There was a significant increase in hip extension force between three and six month intervals in all four
groups and in both operated (case) and non-operated (control) limbs (P<0.05, 95% CI). However, there was more
increase in case limbs in comparison to control limbs. There was no significant difference in hip extension strength
among all four groups (both in case and control limbs) in the third- and the sixth-month post-operative tests.
Conclusion: Graft type had no effect on hip extension strength following ACL reconstruction, and the harvest of one or
both hamstrings had no deleterious effect on hip extension force.
Level of evidence: III

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