Hip extension strength following hamstring tendon harvest for ACL reconstruction

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Biomechanics

Background:

• Anterior cruciate ligament (ACL) reconstruction often uses hamstring autografts.
• Potential impact of hamstring harvest on hip extension strength is crucial for athletes in high-speed running sports.
• Previous research has not specifically evaluated this functional deficit.

Purpose of the Study:

• To compare isokinetic hip extension strength after ACL reconstruction using four-strand semitendinosus and gracilis tendons (4SHS) versus bone-patellar tendon-bone (BPTB) autografts.
• To assess the short-term and long-term effects on hip extension strength in athletes.

Main Methods:

• A non-randomized prospective case control study design.
• Isokinetic hip extension strength measured using a Kin-Com machine at 30 degrees/second.
• Assessment at 3 and 12 months post-operatively in ACL reconstruction patients.

Main Results:

• A significant decrease in peak concentric hip extension force was observed in the 4SHS group at 3 months post-operatively (p<0.05).
• No significant difference in hip extension strength was found between the 4SHS and BPTB groups at 12 months post-operatively.
• This indicates a transient, not persistent, deficit in hip extension strength.

Conclusions:

• ACL reconstruction with 4SHS hamstring autografts causes a temporary reduction in hip extension strength.
• Hip extension strength recovers by 12 months post-surgery, comparable to BPTB autografts.
• 4SHS hamstring autografts are suitable for ACL reconstruction in athletes prioritizing hip extension strength preservation.