Document Type
Article
Publication Date
12-2022
Publisher
Lippincott, Williams & Wilkins
Source Publication
Medicine & Science in Sports & Exercise
Source ISSN
0195-9131
Original Item ID
DOI: 10.1249/mss.0000000000003009
Abstract
Purpose
Bone–patellar tendon–bone (BPTB) graft harvest for anterior cruciate ligament reconstruction alters patellar tendon properties, which inflict poor quadriceps neuromuscular function. BPTB autografts are associated with higher rates of posttraumatic osteoarthritis, which in turn is associated with pathological gait. The purpose of this study was to investigate the latency between the time of peak quadriceps activity and the peak knee flexion moment during gait, between those with BPTB grafts (n = 23) and other graft types (hamstring autograft or allografts, n = 54), 5 ± 2 months and 2 yr (25 ± 3 months) after anterior cruciate ligament reconstruction. We hypothesized that longer latencies would be observed in the BPTB graft group in the involved limb. We expected latencies to shorten over time.
Methods
Knee moments and quadriceps EMG were collected during gait, and vastus medialis, vastus lateralis, rectus femoris (RF), and quadriceps latencies were calculated. Linear mixed-effects models were used to compare latencies between graft types and over the two time points.
Results
The main effects of graft type were observed for vastus medialis (P = 0.005) and quadriceps (P = 0.033) latencies with the BPTB graft group demonstrating longer latencies. No main effects of graft type were observed for vastus lateralis (P = 0.051) and RF (P = 0.080) latencies. Main effects of time were observed for RF latency (P = 0.022).
Conclusions
Our hypothesis that the BPTB graft group would demonstrate longer extensor latency was supported. Contrary to our second hypothesis, however, latency only improved in RF and regardless of graft type, indicating that neuromuscular deficits associated with BPTB grafts may persist 2 yr after surgery. Persistent deficits may be mediated by changes in the patellar tendon’s mechanical properties. Graft-specific rehabilitation may be warranted to address the long-term neuromechanical deficits that are present after BPTB graft harvest.
Recommended Citation
Ito, Naoaki; Capin, Jacob J.; Khandha, Ashutosh; Buchanan, Thomas S.; Silbernagel, Karin Grävare; and Snyder-Mackler, Lynn, "Bone–Patellar Tendon–Bone Autograft Harvest Prolongs Extensor Latency during Gait 2 yr after ACLR" (2022). Physical Therapy Faculty Research and Publications. 209.
https://epublications.marquette.edu/phys_therapy_fac/209
Comments
Accepted version. Medicine & Science in Sports & Exercise, Vol. 54, No. 12 (December 2022): 2109-2117. DOI. © 2022 American College of Sports Medicine. Used with permission.