Biology of Sport
eISSN: 2083-1862
ISSN: 0860-021X
Biology of Sport
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abstract:
Original paper

Late-stage rehabilitation effects do not differ between quadriceps and hamstring tendon autograft after anterior cruciate ligament reconstruction: a multicentre propensity score-matched case-control intervention trial

Daniel Niederer
1, 2
,
Matthias Keller
3
,
Wolf Petersen
4
,
Natalie Mengis
5, 6
,
Christian Eberle
5
,
Daniel Guenther
7
,
Georg Brandl
8
,
Björn H. Drews
9
,
Tobias Engeroff
1
,
Lutz Vogt
10
,
David A. Groneberg
1
,
Thomas Stein
10, 11

  1. Institute of Occupational, Social and Environmental Medicine, Goethe University Frankfurt
  2. Department of Movement and Training Science, Faculty of Humanities and Social Sciences, Institute of Sport Science, University of Wuppertal, Wuppertal, Germany
  3. OSINSTITUT ortho & sport, Munich, Germany
  4. Klinik für Orthopädie und Unfallchirurgie, Berlin, Germany
  5. Arcus Sportklinik, Pforzheim, Germany
  6. KSA Aarau/Spital Zofingen, Switzerland; University Hospital, Basel, Switzerland
  7. Department of Orthopaedic Surgery, Trauma Surgery, and Sports Medicine, Cologne Merheim Medical Center, Witten/Herdecke University, Germany
  8. Department of Orthopaedic Surgery II, Herz-Jesu Krankenhaus, Vienna, Austria
  9. St. Vinzenz Clinic Allgäu, Pfronten, Germany
  10. Department of Sports Medicine and Exercise Physiology; Goethe University Frankfurt, Frankfurt am Main, Germany
  11. SPORTHOLOGICUM Frankfurt – Center for Sport and Joint injuries, Frankfurt am Main, Germany
Biol Sport. 2025;42(2):135–149
DOI: https://doi.org/10.5114/biolsport.2025.142647
Online publish date: 2024/10/15
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Late-stage rehabilitation interventions after an anterior cruciate ligament (ACL) reconstruction are under-researched, inter alia regarding potential differences in rehabilitation effects between autograft types. This study determined the effectiveness of a specific, late-stage rehabilitation to usualcare after ACLreconstructions in patients with a quadriceps versus such with a hamstring tendon autograft. In this multicentre case-control intervention study, participants aged 18–35 years were included at the end of their formal rehabilitation (mean 8.1 months) after ACL reconstruction. Twenty-four cases with an arthroscopically assisted, anatomic ipsilateral quadriceps femoris tendon autograft and two numerically equal hamstring tendon reconstructed propensity score-matched groups were compared. Matching variables were gender, age, Tegner activity scale, plus, once, the time since reconstruction and once the functional capacity at intervention onset. All participants performed a 5-month performance enhancing intervention. All outcomes were measured once a month. Self reported outcomes such as knee function (The Knee injury and Osteoarthritis Outcome Score (KOOS) Sport as the main self-reported outcome) were followed by a series of hop and jump tests. The front hops for distance (outcome: hopping distance) was the primary outcomes of the study. Linear mixed models were calculated using change scores. All participants were analysed. No group*time interaction effect could be identified in the two main outcomes KOOS SPORT and front hop for distance. Furthermore, with the exception of the self-reported all-day function, no outcome displayed any between-group differences in the trainability, either. The return-to-sport success took a mean time of 3.8 months after study commencement; the success rates ranged between 80% and 83% and were not different between groups. Being with a hamstrings or with a quadriceps tendon autograft had no impact on the late-stage rehabilitation effects after an ACL rupture. Both graft choices enable comparably favourable functional outcomes and return-to-sport success rates. Conversely, no recommendation can be derived with regard to the selection of either a hamstring or a quadriceps autograft type. The decision must be undertaken individually and based on other factors.
keywords:

Propensity score, Autograft, Functional capacity, Return to sports, RTS, Intervention, Re-injury

  
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