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Quadriceps strength and functional capacity after anterior cruciate ligament reconstruction

Patellar tendon autograft versus allograft

Sports Medicine Program, Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania

Mininder S. Kocher, MD

Sports Medicine Program, Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania

Christopher D. Harner, MD

Sports Medicine Program, Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania

Freddie H. Fu, MD

Sports Medicine Program, Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania

Harvesting the central third of the patellar tendon for autograft anterior cruciate ligament reconstruction is thought to compromise quadriceps strength and func tional capacity. We compared objective measurements of quadriceps strength and functional capacity in ath letes after patellar tendon autograft or allograft anterior cruciate ligament reconstruction. We looked at 33 ac tive male patients (mean age, 24.3 years) who had anterior cruciate ligament reconstructions 12 to 24 months earlier using patellar tendon autograft (N = 15) or allograft (N = 18) techniques. All patients under went an intensive rehabilitation program. Quadriceps strength and power were assessed by measuring peak torque at 60 and 240 deg/sec, torque acceleration energy at 240 deg/sec, and the quadriceps index using a Cybex II isokinetic testing device. Functional capacity was evaluated based on the results of 3 specially designed functional performance tests and the hop test. Results revealed no significant difference between au tograft and allograft groups with respect to any of these parameters. These findings indicate that harvesting the central third of the patellar tendon for autograft anterior cruciate ligament reconstruction does not diminish quadriceps strength or functional capacity in highly active patients who have intensive rehabilitation. Thus, the recommendation to avoid patellar tendon autograft anterior cruciate ligament reconstruction to preserve quadriceps strength and functional capacity may be unnecessary.

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