Original Article
Hamstring-Dominant Strategy of the Bone–Patellar Tendon–Bone Graft Anterior Cruciate Ligament–Reconstructed Leg Versus Quadriceps-Dominant Strategy of the Contralateral Intact Leg During High-Intensity Exercise in Male Athletes

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Purpose

The purpose of this study was to investigate the effect of anterior cruciate ligament (ACL) reconstruction on the quadriceps-dominant strategy as a parameter associated with the neuromuscular control of the knee joint.

Methods

In this study 14 competitive soccer players who had undergone ACL reconstruction with bone–patellar tendon–bone autograft and 14 healthy competitive soccer players performed two 10-minute treadmill runs, 1 at moderate intensity and 1 at high intensity. Electromyographic recordings were acquired by use of a telemetric system at the third, fifth, seventh, and tenth minute of the runs from the vastus lateralis and the biceps femoris bilaterally. The dependent variable examined was the peak electromyographic amplitude during the stance phase. Analyses of variance were used to examine significant main effects and interactions.

Results

Vastus lateralis electromyographic activity during high-intensity running increased for both the control leg and intact leg (F = 4.48, P < .01), whereas it remained unchanged for the reconstructed leg (P > .05). Biceps femoris electromyographic activity during high-intensity running increased for the reconstructed leg only compared with both the control leg (F = 3.03, P < .05) and intact leg (F = 3.36, P < .03).

Conclusions

There is no presence of the quadriceps-dominant strategy in ACL-reconstructed athletes during moderate-intensity exercise. During high-intensity exercise, the intact contralateral leg develops the quadriceps-dominant strategy whereas the reconstructed leg does not. The reconstructed leg instead increases biceps femoris activity, developing a “hamstring-dominant” strategy, and this “asymmetry” may theoretically be in favor of the reconstructed knee.

Level of Evidence

Level III, retrospective comparative study.

Section snippets

Methods

Two groups of athletes participated in the study. The first group consisted of a consecutive series of 14 competitive male soccer players with ACL-reconstructed knees (mean age, 24.8 years [SD, 5.3 years]; mean body mass, 77.3 kg [SD, 7.5 kg]; mean height, 177 cm [SD, 5.3 cm]), and the second group consisted of 14 healthy competitive male soccer players who had never had any kind of orthopaedic or neurologic condition (mean age, 21.7 years [SD, 4.4 years]; mean body mass, 72.2 kg [SD, 8.3 kg];

Clinical Results

At the time of data collection, no clinical evidence of knee pain and effusion was found in the ACL-reconstructed subjects. All subjects in the ACL-reconstructed group were satisfied with the outcome of surgery and resumed their preinjury level of sports participation. Negative Lachman and pivot-shift tests indicated that the knee joint stability was regained clinically for all ACL-reconstructed subjects. For the subjects with ACL reconstruction, the median Lysholm score was 95 (range, 94 to

Discussion

The purpose of this study was to investigate the effect of ACL reconstruction on the quadriceps-dominant strategy during moderate- and high-intensity running. We hypothesized that (1) during moderate-intensity exercise, there will be no evidence of the quadriceps-dominant strategy for the control, intact contralateral, or ACL-reconstructed leg, and (2) during high-intensity exercise, the quadriceps-dominant strategy will be evident for the control and intact contralateral legs but not the

Conclusions

There is no presence of the quadriceps-dominant strategy in ACL-reconstructed athletes during moderate-intensity exercise. During high-intensity exercise, the intact contralateral leg develops the quadriceps-dominant strategy whereas the ACL-reconstructed leg does not. The reconstructed leg instead increases BF activity, developing a hamstring-dominant strategy, and this asymmetry may theoretically be in favor of the reconstructed knee.

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    The authors report that they have no conflicts of interest in the authorship and publication of this article.

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    Copyright © 2012 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.