Abstract
2/2025
vol. 42
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
- Institute of Occupational, Social and Environmental Medicine, Goethe University Frankfurt
- Department of Movement and Training Science, Faculty of Humanities and Social Sciences, Institute of Sport Science, University of Wuppertal, Wuppertal, Germany
- OSINSTITUT ortho & sport, Munich, Germany
- Klinik für Orthopädie und Unfallchirurgie, Berlin, Germany
- Arcus Sportklinik, Pforzheim, Germany
- KSA Aarau/Spital Zofingen, Switzerland; University Hospital, Basel, Switzerland
- Department of Orthopaedic Surgery, Trauma Surgery, and Sports Medicine, Cologne Merheim Medical Center, Witten/Herdecke University, Germany
- Department of Orthopaedic Surgery II, Herz-Jesu Krankenhaus, Vienna, Austria
- St. Vinzenz Clinic Allgäu, Pfronten, Germany
- Department of Sports Medicine and Exercise Physiology; Goethe University Frankfurt, Frankfurt am Main, Germany
- SPORTHOLOGICUM Frankfurt – Center for Sport and Joint injuries, Frankfurt am Main, Germany
Biol Sport. 2025;42(2):135–149
Online publish date: 2024/10/15
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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