Quadriceps Strength following Anterior Cruciate Ligament Reconstruction: Normative Values based on Sex, Graft Type and Meniscal Status at 3, 6 & 9 Months

Nicole A Schwery; Michael T Kiely; Christopher M Larson; Corey A Wulf; Christie S Heikes; Ryan W Hess; M Russell Giveans; Braidy S Solie; Chrisopher P Doney

doi:10.26603/001c.32378

Quadriceps Strength following Anterior Cruciate Ligament Reconstruction: Normative Values based on Sex, Graft Type and Meniscal Status at 3, 6 & 9 Months

Int J Sports Phys Ther. 2022 Apr 1;17(3):434-444. doi: 10.26603/001c.32378. eCollection 2022.

Authors

Nicole A Schwery¹, Michael T Kiely¹, Christopher M Larson², Corey A Wulf², Christie S Heikes², Ryan W Hess³, M Russell Giveans⁴, Braidy S Solie¹, Chrisopher P Doney¹

Affiliations

¹ Training HAUS at Twin Cities Orthopedics, Eagan, MN, USA.
² Twin Cities Orthopedics, Edina, MN, USA.
³ Twin Cities Orthopedics, Robbinsdale, MN, USA.
⁴ Training HAUS at Twin Cities Orthopedics, Eagan, MN, USA; Twin Cities Orthopedics, Edina, MN, USA.

Abstract

Background: Higher postoperative quadriceps function has been positively associated with surgical outcomes after anterior cruciate ligament reconstruction (ACLR). However, the impact of autograft harvest and/or a concomitant meniscal procedure on the recovery of quadriceps strength is not well defined.

Purpose: To describe postoperative recovery of quadriceps strength following ACLR related to autograft selection, meniscal status, and sex.

Study design: Retrospective Cohort.

Methods: One hundred and twenty-five participants who underwent ACLR with either a hamstring tendon (HT), bone-patellar tendon-bone (BPTB) or quadriceps tendon (QT) autograft were included. At postoperative months 3, 6 and 9, each participant completed an isometric quadriceps strength testing protocol at 90-degrees of knee flexion. Participants' quadriceps average peak torque (Q-AvgPKT), average peak torque relative to body weight (Q-RPKT), and calculated limb symmetry index (Q-LSI) were collected and used for data analysis. Patients were placed in groups based on sex, graft type, and whether they had a concomitant meniscal procedure at the time of ACLR. At each time point, One-way ANOVAs, independent samples t-test and chi-square analyses were used to test for any between-group differences in strength outcomes.

Results: At three months after ACLR, Q-RPKT was significantly higher in those with the HT compared to the QT. At all time points, males had significantly greater Q-RPKT than females and HT Q-LSI was significantly higher than BPTB and QT. A concomitant meniscal procedure at the time of ACLR did not significantly affect Q-LSI or Q-RPKT at any testing point.

Conclusion: This study provides outcomes that are procedure specific as well as highlights the objective progression of quadriceps strength after ACLR. This information may help better-define the normal recovery of function, as well as guide rehabilitation strategies after ACLR.

Level of evidence: 3.

Keywords: anterior cruciate ligament reconstruction; isometric; meniscus; quadriceps; strength.