Patellar and hamstring autografts are associated with different jump task loading asymmetries after ACL reconstruction
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Accepted Version
Date
2019-04-29
Authors
Miles, Joshua J.
King, Enda
Falvey, Éanna
Daniels, Katherine A. J.
Journal Title
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Publisher
John Wiley & Sons, Inc.
Published Version
Abstract
After anterior cruciate ligament reconstruction (ACLR), there is a higher re-injury rate to the contralateral limb in athletes who undergo surgery using a bone-patellar-tendon-bone (BPTB) autograft than using a semitendinosus and gracilis hamstring tendon (HT) autograft. This may be influenced by differing lower-limb loading asymmetries present when athletes of each graft type return to play (RTP). The aim of this study was to compare bilateral countermovement jump (CMJ) phase-specific impulse asymmetries between athletes with BPTB and HT autografts 9 months post-ACLR, and to identify the relationship between impulse and isokinetic strength asymmetries. Male field sport athletes with a BPTB (n = 22) or HT (n = 22) autograft were tested approximately 9 months post-ACLR. An uninjured control group (n = 22) was also tested on a single occasion. Phase-specific bilateral absolute impulse asymmetries were calculated during the CMJ and compared between groups using Kruskal-Wallis and post-hoc testing. A linear regression model was used to assess the relationship between impulse asymmetries and isokinetic concentric knee extensor strength asymmetries. BPTB athletes demonstrated greater impulse asymmetries than HT athletes during the eccentric (P = 0.01) and concentric (P = 0.008) phases of the jump. Isokinetic strength asymmetry was a significant predictor of CMJ concentric impulse asymmetry in both BPTB (r2 = 0.39) and HT athletes (r2 = 0.18) but not eccentric impulse asymmetry in any group. The greater loading asymmetries demonstrated by BPTB than HT athletes 9 months after ACLR may contribute to the differing incidence rates of contralateral ACL injury. The findings suggest that graft-specific loading asymmetries should be targeted during rehabilitation prior to RTP.
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Keywords
Biomechanics , Countermovement jump , Ground reaction force , IKDC , Impulse , Isokinetic dynamometry , Phase‐specific
Citation
Miles, J. J., King, E., Falvey, É.C., Daniels, K. A. J. (2019) 'Patellar and hamstring autografts are associated with different jump task loading asymmetries after ACL reconstruction', Scandinavian Journal of Medicine & Science in Sports, 29(8), pp. 1212-1222. https://doi.org/10.1111/sms.13441
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© 2019, John Wiley & Sons A/S. Published by John Wiley & Sons Ltd. This is the accepted version of the following item: Miles, J. J., King, E., Falvey, É.C., Daniels, K. A. J. (2019) 'Patellar and hamstring autografts are associated with different jump task loading asymmetries after ACL reconstruction', Scandinavian Journal of Medicine & Science in Sports, 29(8), pp. 1212-1222, which has been published in final form at: https://doi.org/10.1111/sms.13441. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions.