Abstract
PURPOSE: To compare the effect of bone-patellar tendon-bone (BTB), hamstring tendon (HS), and iliotibial band (ITB), on physical and functional recovery at 6-month post-anterior cruciate ligament reconstruction (ACLR). METHODS: A prospective cohort study design was used. At 6-month post-operative visits following ACLR, bilateral strength (quadriceps, hamstrings, hip abductor, and hip extensor), Y-balance (anterior, posterolateral, and posteromedial reach), and hop (single, triple, cross-over, and timed hops) tests were assessed from adolescent males. Deficits between ACLR and uninvolved limb was compared using paired t-tests. The deficits were further compared among graft types with analysis of covariance (ANCOVA) including demographics (height, weight, and age) and meniscus tear differences. RESULTS: A total of 71 male ACLR patients (mean age: 16.7±2.2) were enrolled. The BTB group demonstrated reduced quadriceps strength in the ACLR limb compared to uninvolved limb (19%, p=0.004). The HS group showed reduced hamstring strength in the ACLR limb relative to uninvolved limb (29%, p=0.001). ANCOVA detected significant quadriceps (p=0.001) and hamstring (p=0.001) deficits of BTB and HS cohorts compared to ITB cohort, respectively. The poorer anterior (13%, p=0.006) and posterolateral reach (3%, p=0.038) performance of ACLR limb were recorded in BTB and HS groups, and ANCOVA indicated the anterior reach deficits of BTB group was significant compared to ITB (p=0.022). BTB cohort showed slower timed hop in ACLR limb (12%, p=0.037). The HS group showed shorter single (10%, p=0.001) and triple hop distances (7%, p=0.001) as well as slower timed hop (5%, p=0.008) in ACLR limb. However, the ANCOVA did not find differences in hop outcome among graft types. CONCLUSIONS: Autograft type influences strength and functional parameters following ACLR in adolescent males. 6 months may not be sufficient time period for safe return to sports, especially BTB and HS graft types. Rehabilitative emphasis need be placed on optimal physical and functional development, particularly in muscle groups involving donor sites.
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