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Related Experiment Video

Updated: Jun 5, 2026

Early Weight-Bearing Rehabilitation Protocol After Anterior Cruciate Ligament Reconstruction
05:07

Early Weight-Bearing Rehabilitation Protocol After Anterior Cruciate Ligament Reconstruction

Published on: March 1, 2024

Factors explaining chronic knee extensor strength deficits after ACL reconstruction.

Chandramouli Krishnan1, Glenn N Williams

  • 1Searle Laboratory, Sensory Motor Performance Program, Rehabilitation Institute of Chicago, Chicago, Illinois, USA. ckrishnan@ric.org

Journal of Orthopaedic Research : Official Publication of the Orthopaedic Research Society
|January 20, 2011
PubMed
Summary

Persistent quadriceps weakness after anterior cruciate ligament (ACL) reconstruction is linked to peripheral muscle changes, not voluntary activation or hamstring strength. These findings clarify long-term strength deficits post-ACL surgery.

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Area of Science:

  • Orthopedics
  • Sports Medicine
  • Rehabilitation Science

Background:

  • Persistent quadriceps muscle weakness is a common issue following anterior cruciate ligament (ACL) reconstruction.
  • The underlying mechanisms contributing to these chronic strength deficits remain unclear.
  • Understanding these mechanisms is crucial for improving rehabilitation outcomes.

Purpose of the Study:

  • To investigate the relationship between chronic quadriceps weakness and voluntary muscle activation, antagonistic hamstring moments, and peripheral muscle changes in individuals with a history of ACL reconstruction.
  • To identify the primary factors contributing to persistent knee extensor strength deficits years after ACL reconstruction.

Main Methods:

  • Evaluated knee extensor strength and voluntary quadriceps activation using the interpolated triplet technique in 15 ACL-reconstructed and 15 control subjects.

Related Experiment Videos

Last Updated: Jun 5, 2026

Early Weight-Bearing Rehabilitation Protocol After Anterior Cruciate Ligament Reconstruction
05:07

Early Weight-Bearing Rehabilitation Protocol After Anterior Cruciate Ligament Reconstruction

Published on: March 1, 2024

  • Assessed peripheral muscle adaptations in the quadriceps via electrically evoked contractile properties.
  • Predicted antagonistic hamstring moments using a mathematical model.

    • Main Results:

    • ACL-reconstructed legs exhibited significantly lower knee extensor strength and evoked torque at rest compared to controls.
    • Voluntary quadriceps activation and antagonistic hamstring activity were comparable between the ACL-reconstructed and control groups.
    • Differences in evoked torque at rest explained 71% of the side-to-side knee extensor strength deficits in the ACL group.

    Conclusions:

    • Chronic quadriceps weakness after ACL reconstruction in this cohort is primarily attributed to peripheral changes within the quadriceps muscle itself.
    • Voluntary muscle activation levels and antagonistic hamstring activity do not appear to be significant contributors to long-term quadriceps weakness post-ACL reconstruction.
    • These findings highlight the importance of addressing peripheral muscle adaptations during the rehabilitation process for ACL injuries.