Anterior Cruciate Ligament Reconstruction with Hamstring Tendons Has no Deleterious Effect on Hip Extension Strength

Abstract

Background: Hamstring tendons are secondary hip extensors. Their harvest for graft in anterior cruciate ligament<br />(ACL) reconstruction may create deleterious effect on hip extension strength. This is of particular importance in sports<br />that need powerful hip extension force like climbing and sprinting. Due to scarcity of a comprehensive study in this<br />area, we designed this prospective study to evaluate hip extension strength following ACL reconstruction using different<br />types of grafts.<br />Methods: Fifty eight patients were enrolled in this prospective non-randomized case control study to compare<br />isokinetic hip extension strength following ACL reconstruction with different graft types. Twenty patients in group<br />A (both Semitendinosus and Gracilis tendons autograft (ST-G)), 14 patients in group B (Tibialis Posterior tendon<br />allograft (Allograft)), 12 patients in group C (bone-patellar tendon-bone autograft (BPTB)) and 12 patients in group D<br />(only semitendinosus autograft (ST)) were studied. Hip extension strength was tested post-operatively at three- and<br />six-month periods using a Biodex isokinetic testing machine at a speed of 30 degree per second in operated (cases)<br />and non-operated (controls) limbs.<br />Results: There was a significant increase in hip extension force between three and six month intervals in all four<br />groups and in both operated (case) and non-operated (control) limbs (P<0.05, 95% CI). However, there was more<br />increase in case limbs in comparison to control limbs. There was no significant difference in hip extension strength<br />among all four groups (both in case and control limbs) in the third- and the sixth-month post-operative tests.<br />Conclusion: Graft type had no effect on hip extension strength following ACL reconstruction, and the harvest of one or<br />both hamstrings had no deleterious effect on hip extension force.<br />Level of evidence: III