The effect of anterior cruciate ligament reconstruction on hamstring and quadriceps muscle function outcome ratios in male athletes

Abstract

The assessment of RFD may be considered an objective recovery parameter for one's readiness to return to sports and should be an integral part of standard follow-up protocol for athletes after ACL reconstruction. Moreover, the combination of indices derived from maximal and explosive strength may provide better insight in muscle strength balance, as well as a clear picture of functional implications.

Contractile rate of force development after anterior cruciate ligament reconstruction—a comprehensive review and meta‐analysis

“…Interestingly, participants in a study by Pamukoff et al 66 demonstrated full symmetry of knee extensors 4 years after ACLR and RFD deficits were observed only when comparing the ACLR group to an uninjured control group (5%-23%). Between-limb asymmetries in knee flexor RFD were of a moderate-to-high magnitude four to 6 months after ACLR (11%-32%) 71,72 while approaching small-to-moderate magnitude at later time points of 1 65 to 2 58 years after ACLR surgery (5%-13%).…”

“…The present systematic review suggests that between-limb asymmetries in RFD after ACLR may persist for several years post-operatively for both the knee extensors and the knee flexors. Between-limb asymmetry in the knee extensor RFD (26%-57%) was highest four to 7 months post-ACLR 56,59,69,71,72 and decreased through to 1 year after ACLR 65 (knee extensor RFD asymmetry 21%-29%). Knee extensor RFD asymmetry was still present 2 58 (20%-23%) to 4 years 63,67 (11%-22%) after ACLR.…”

“…ACLR group between-limb asymmetry in knee flexor RFD assessed as (A) early-phase RFD (<100 ms) and (B) late-phase RFD (≥100 ms) ACLR. Knee extensor RFD data comparing the ACLR limb to the uninjured limb were pooled from 10 studies comprising a total of 246 participants 35,47,49,50,57,59,65,66,70,71 and five studies totaling 78 participants for knee flexor RFD. 56,58,65,71,72 Comparisons between participants with and without ACLR were pooled from four studies (n = 211 participants).…”

“…Knee extensor RFD data comparing the ACLR limb to the uninjured limb were pooled from 10 studies comprising a total of 246 participants 35,47,49,50,57,59,65,66,70,71 and five studies totaling 78 participants for knee flexor RFD. 56,58,65,71,72 Comparisons between participants with and without ACLR were pooled from four studies (n = 211 participants). 47,66,69,73 As the main study finding, ACLR resulted in substantial between-limb asymmetry (ie, ACLR limb deficits) in RFD, evidenced by moderate-to-large (>0.7) SMDs in early-and late-phase RFD for both the knee extensors and flexors.…”

“…Bone-patellar tendon-bone (BPTB) autografts were mostly used for ACLR in the present analysis. 56,58,59,[65][66][67][68][71][72][73] This may explain the more marked and persistent between-limb asymmetry in knee extensor RFD compared to knee flexor RFD. 9,71 In support of this notion, between-limb asymmetry deficits based on MVC also have been observed for the knee extensors in individuals with BPTB autograft.…”