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- Title
Effect of Quadriceps and Hamstring Strength Relative to Body Weight on Risk of a Second ACL Injury: A Cohort Study of 835 Patients Who Returned to Sport After ACL Reconstruction.
- Authors
Simonson, Rebecca; Piussi, Ramana; Högberg, Johan; Senorski, Carl; Thomeé, Roland; Samuelsson, Kristian; Senorski, Eric Hamrin
- Abstract
Background: Anterior cruciate ligament (ACL) injuries are common sports-related injuries with a high risk of reinjury after return to sport (RTS). Rehabilitation aims to regain symmetrical knee strength and function to minimize the risk of a second ACL injury after RTS. Purpose: To determine the effect of absolute quadriceps and hamstring strength, normalized by body weight, on the risk of a second ACL injury during the first 2 years after RTS in patients who have undergone ACL reconstruction (ACLR). Study Design: Cohort study; Level of evidence, 3. Methods: Data from patients after index ACLR at the time of RTS were extracted from a rehabilitation registry—Project ACL. Patients who had performed isokinetic tests for quadriceps and hamstring strength and hop tests before RTS were included. The endpoint was a second ACL injury or a follow-up of 2 years after RTS after ACLR. Results: A total of 835 patients (46% women), with a mean age of 23.9 ± 7.7 years, were included. During the study period, 69 (8.3%) second ACL injuries (ipsilateral and contralateral) occurred. Greater relative quadriceps strength in the injured leg increased the risk of a second ACL injury (relative risk [RR], 1.69 [95% CI, 1.05-2.74]; P =.032). In patients who had recovered symmetrical quadriceps strength (limb symmetry index ≥90%), there was no effect of quadriceps strength on the risk of second ACL injury (RR, 1.33 [95% CI, 0.69-2.56]; P =.39). Quadriceps strength on the healthy side or hamstring strength, regardless of side, had no effect on the risk of a second ACL injury. Conclusion: Greater relative quadriceps strength in the injured leg at the time of RTS after ACLR was associated with an increased risk of a second ACL injury. There was no effect of relative quadriceps strength on the risk of a second ACL injury in patients who had recovered symmetrical quadriceps strength.
- Subjects
SWEDEN; INJURY risk factors; SPORTS participation; RELATIVE medical risk; BODY weight; CONFIDENCE intervals; SPORTS injuries; SURGICAL complications; SURGERY; PATIENTS; RISK assessment; ANTERIOR cruciate ligament injuries; QUADRICEPS muscle; HAMSTRING muscle; MUSCLE strength; RESEARCH funding; DESCRIPTIVE statistics; ANTERIOR cruciate ligament surgery; LONGITUDINAL method; DISEASE risk factors
- Publication
Orthopaedic Journal of Sports Medicine, 2023, Vol 11, Issue 4, p1
- ISSN
2325-9671
- Publication type
Article
- DOI
10.1177/23259671231157386