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Original Research

Open Access

Functional outcome and single hop test results of ACL reconstruction in athletes at a follow-up of 6 and 12 months: modified all-inside versus conventional hamstring autograft

  • Burak Yoldaş1,†
  • Ali Kerim Yılmaz2,*,†,
  • Coşkun Yılmaz3
  • Enes Akdemir2
  • Berna Anıl2
  • Merve Demir Benli4
  • Ahmet Serhat Genç5
  • Lokman Kehribar6

1Department of Orthopedics and Traumatology, Samsun Havza State Hospital, 55700 Samsun, Turkey

2Faculty of Yasar Doğu Sport Sciences, Ondokuz Mayıs University, 55270 Samsun, Turkey

3Kelkit Aydın Doğan Vocational School, Gümüşhane University, 29600 Gümüşhane, Turkey

4Department of Sports Medicine, Faculty of Medicine, Dokuz Eylül University, 35340 İzmir, Turkey

5Department of Orthopedics and Traumatology, Samsun Education and Research Hospital, 55090 Samsun, Turkey

6Department of Orthopaedics and Traumatology, Faculty of Medicine, Dokuz Eylül University, 35340 İzmir, Turkey

DOI: 10.22514/jomh.2024.082

Submitted: 26 March 2024 Accepted: 08 May 2024

Online publish date: 19 June 2024

*Corresponding Author(s): Ali Kerim Yılmaz E-mail: akerim.yilmaz@omu.edu.tr

† These authors contributed equally.

Abstract

Anterior cruciate ligament (ACL) tears are injuries with a high incidence in athletes, and ACL reconstruction (ACLR) is a surgical treatment orthopedists perform. This study aims to compare the 6 and 12 months post-op results of single leg hop tests (SLHT) performed in multidirectional conventional semitendinosus/gracilis (ST/G) and modified all inside (MAI) ACLR techniques on both sides and the limb symmetry indexes (LSI) of both techniques. This study evaluated a retrospective cohort of 50 male athletes who applied MAI (n = 23) and traditional ACLR ST/G (n = 27) techniques. Functional knee strength of the participants on both sides was measured with different SLHTs at 6 and 12 months postoperatively. The SLHT included medial side (MSTH), triple hop (TH), medial rotation (90◦) (MRH), crossover triple (CH) ve the single hop (SH) hop for distance. Both ACLR techniques showed significant improvement in mean Tegner, International Knee Documentation Committee (IKDC) and Lysholm scores preoperatively and at 6 and 12 months postoperatively (p < 0.05). For MAI and ST/G techniques, there was no significant difference in the results of SLHTs at 6 and 12 months for both the operated and non-operated sides (p < 0.05). Significance was found only in the MRH test of the non-operated side (p < 0.05). There was no significant difference in SLHT scores between the operated and non-operated sides at 6 and 12 months postoperatively (p > 0.05). There was no difference in LSI scores between techniques (p < 0.05). Our study revealed similar LSI rates in ST/G and MAI techniques at 6 and 12 months, suggesting that MAI technique can be used as a functional ACLR technique for athletes.


Keywords

Interference screw; Anterior cruciate ligament reconstruction; Return to sport; Hop test; Cortical suspensory fixation


Cite and Share

Burak Yoldaş,Ali Kerim Yılmaz,Coşkun Yılmaz,Enes Akdemir,Berna Anıl,Merve Demir Benli,Ahmet Serhat Genç,Lokman Kehribar. Functional outcome and single hop test results of ACL reconstruction in athletes at a follow-up of 6 and 12 months: modified all-inside versus conventional hamstring autograft. Journal of Men's Health. 2024.doi:10.22514/jomh.2024.082.

References

[1] Kitaguchi T, Tanaka Y, Takeshita S, Akizaki K, Takao R, Kinugasa K, et al. Preoperative quadriceps strength as a predictor of return to sports after anterior cruciate ligament reconstruction in competitive athletes. Physical Therapy in Sport. 2020; 45: 7–13.

[2] Achermann S, Marty J, Beck A, Rieger B, Hirschmüller A, Baur H. Rückkehr zum Sport nach Rekonstruktion des vorderen Kreuzbandes—Welche Faktoren beeinflussen die Return to Sport-Entscheidung? Sportverletzung · Sportschaden. 2023; 37: 133–140. (In German)

[3] Kuliński K, Waśko MK, Tramś E, Malesa K, Pomianowski S, Kamiński R. Anterior cruciate ligament reconstruction using a 4-strand semitendinosus tendon graft or a doubled semitendinosus and gracilis tendon graft: a 4.5-year prospective, randomized, double-blind, parallel-group study. The American Journal of Sports Medicine. 2023; 51: 615–626.

[4] Petre BM, Smith SD, Jansson KS, de Meijer P, Hackett TR, LaPrade RF, et al. Femoral cortical suspension devices for soft tissue anterior cruciate ligament reconstruction. The American Journal of Sports Medicine. 2013; 41: 416–422.

[5] Saccomanno MF, Shin JJ, Mascarenhas R, Haro M, Verma NN, Cole BJ, et al. Clinical and functional outcomes after anterior cruciate ligament reconstruction using cortical button fixation versus transfemoral suspensory fixation: a systematic review of randomized controlled trials. Arthroscopy: The Journal of Arthroscopic & Related Surgery. 2014; 30: 1491–1498.

[6] Lubowitz JH, Amhad CH, Anderson K. All-inside anterior cruciate ligament graft-link technique: second-generation, no-incision anterior cruciate ligament reconstruction. Arthroscopy: The Journal of Arthroscopic & Related Surgery. 2011; 27: 717–727.

[7] Mahiroğulları M, Kehribar L, Surucu S, Kayaalp ME, Yilmaz AK, Aydin M. Comparative results of anterior cruciate ligament reconstruction with full tibial tunnel: quadrupled semitendinosus suspensory femoral and tibial fixation versus quadrupled semitendinosus and gracilis suspensory femoral and tibial screw and staple fixatio. The Journal of Knee Surgery. 2023; 36: 1069–1076.

[8] Dingenen B, Truijen J, Bellemans J, Gokeler A. Test-retest reliability and discriminative ability of forward, medial and rotational single-leg hop tests. The Knee. 2019; 26: 978–987.

[9] Kehribar L, Yılmaz AK, Karaduman E, Kabadayı M, Bostancı Ö, Sürücü S, et al. Post-operative results of ACL reconstruction techniques on single-leg hop tests in athletes: hamstring autograft vs. hamstring grafts fixed using adjustable cortical suspension in both the femur and tibia. Medicina. 2022; 58: 435.

[10] Rivera-Brown AM, Frontera WR, Fontánez R, Micheo WF. Evidence for isokinetic and functional testing in return to sport decisions following ACL surgery. PM&R. 2022; 14: 678–690.

[11] Herbawi F, Lozano-Lozano M, Lopez-Garzon M, Postigo-Martin P, Ortiz-Comino L, Martin-Alguacil JL, et al. A systematic review and meta-analysis of strength recovery measured by isokinetic dynamometer technology after anterior cruciate ligament reconstruction using quadriceps tendon autografts vs. hamstring tendon autografts or patellar tendon autografts. International Journal of Environmental Research and Public Health. 2022; 19: 6764.

[12] Barfod KW, Feller JA, Hartwig T, Devitt BM, Webster KE. Knee extensor strength and hop test performance following anterior cruciate ligament reconstruction. The Knee. 2019; 26: 149–154.

[13] Hegedus EJ, McDonough SM, Bleakley C, Baxter D, Cook CE. Clinician-friendly lower extremity physical performance tests in athletes: a systematic review of measurement properties and correlation with injury. Part 2—the tests for the hip, thigh, foot and ankle including the star excursion balance test. British Journal of Sports Medicine. 2015; 49: 649–656.

[14] Logerstedt DS, Scalzitti D, Risberg MA, Engebretsen L, Webster KE, Feller J, et al. Knee stability and movement coordination impairments: knee ligament sprain revision 2017. Journal of Orthopaedic & Sports Physical Therapy. 2017; 47: A1–A47.

[15] Dingenen B, Gokeler A. Optimization of the return-to-sport paradigm after anterior cruciate ligament reconstruction: a critical step back to move forward. Sports Medicine. 2017; 47: 1487–1500.

[16] Abrams GD, Harris JD, Gupta AK, McCormick FM, Bush-Joseph CA, Verma NN, et al. Functional performance testing after anterior cruciate ligament reconstruction. Orthopaedic Journal of Sports Medicine. 2014; 2: 232596711351830.

[17] Rosen AB, Needle AR, Ko J. Ability of functional performance tests to identify individuals with chronic ankle instability: a systematic review with meta-analysis. Clinical Journal of Sport Medicine. 2019; 29: 509–522.

[18] Cournapeau J, Klouche S, Hardy P. Material costs of anterior cruciate ligament reconstruction with hamstring tendons by two different techniques. Orthopaedics & Traumatology: Surgery & Research. 2013; 99: 196–201.

[19] Harrison JJ, Yorgey MK, Csiernik AJ, Vogler JH, Games KE. Clinician-friendly physical performance tests for the knee. Journal of Athletic Training. 2017; 52: 1068–1069.

[20] Gokeler A, Welling W, Zaffagnini S, Seil R, Padua D. Development of a test battery to enhance safe return to sports after anterior cruciate ligament reconstruction. Knee Surgery, Sports Traumatology, Arthroscopy. 2017; 25: 192–199.

[21] Schmitt LC, Paterno MV, Hewett TE. The impact of quadriceps femoris strength asymmetry on functional performance at return to sport following anterior cruciate ligament reconstruction. Journal of Orthopaedic & Sports Physical Therapy. 2012; 42: 750–759.

[22] Myer GD, Schmitt LC, Brent JL, Ford KR, Barber Foss KD, Scherer BJ, et al. Utilization of modified nfl combine testing to identify functional deficits in athletes following ACL reconstruction. Journal of Orthopaedic & Sports Physical Therapy. 2011; 41: 377–387.

[23] Lin R, Zhong Q, Wu X, Cui L, Huang R, Deng Q, et al. Randomized controlled trial of all-inside and standard single-bundle anterior cruciate ligament reconstruction with functional, MRI-based graft maturity and patient-reported outcome measures. BMC Musculoskeletal Disorders. 2022; 23: 289.

[24] Eliya Y, Qureshi A, Kay J, Nagai K, Hoshino Y, de SA D. Anatomical double-bundle anterior cruciate ligament reconstruction moderately improved tegner scores over the long-term: a systematic review and meta-analysis of randomized controlled trials. Knee Surgery, Sports Traumatology, Arthroscopy. 2023; 31: 436–448.

[25] Reid A, Birmingham TB, Stratford PW, Alcock GK, Giffin JR. Hop testing provides a reliable and valid outcome measure during rehabilitation after anterior cruciate ligament reconstruction. Physical Therapy. 2007; 87: 337–349.

[26] Kivlan BR, Carcia CR, Clemente FR, Phelps AL, Martin RL. Reliability and validity of functional performance tests in dancers with hip dysfunction. International Journal of Sports Physical Therapy. 2013; 8: 360–369.

[27] Acar K, Yılmaz AK. Functional dimorphism and relationship between different lower extremity strength tests in young elite judokas. Revista de Artes Marciales Asiáticas. 2021; 16: 56–66.

[28] Munro AG, Herrington LC. Between-session reliability of four hop tests and the agility t-test. Journal of Strength and Conditioning Research. 2011; 25: 1470–1477.

[29] Herrington L, Ghulam H, Comfort P. Quadriceps strength and functional performance after anterior cruciate ligament reconstruction in professional soccer players at time of return to sport. Journal of Strength and Conditioning Research. 2021; 35: 769–775.

[30] Çerçi MH, Yılmaz AK, Kehribar L, Surucu S, Aydin M, Mahiroğulları M. Evaluation of isokinetic knee strengths after ACL reconstruction with quadrupled semitendinosus suspensory femoral and tibial fixation versus four-strand semitendinosus and gracilis suspensory femoral and tibial screw fixation. Journal of Clinical Medicine. 2023; 12: 4004.

[31] Güzel N, Genç AS, Yılmaz AK, Kehribar L. The relationship between lower extremity functional performance and balance after anterior cruciate ligament reconstruction: results of patients treated with the modified all-inside technique. Journal of Personalized Medicine. 2023; 13: 466.

[32] Hardesty K, Hegedus EJ, Ford KR, Nguyen A-D, Taylor JB. Determination of clinically relevant differences in frontal plane hop tests in women’s collegiate basketball and soccer players. International Journal of Sports Physical Therapy. 2017; 12: 182–189.

[33] Sinsurin K, Vachalathiti R, Jalayondeja W, Limroongreungrat W. Different sagittal angles and moments of lower extremity joints during single-leg jump landing among various directions in basketball and volleyball athletes. Journal of Physical Therapy Science. 2013; 25: 1109–1113.

[34] Taylor JB, Ford KR, Nguyen A, Shultz SJ. Biomechanical comparison of single- and double-leg jump landings in the sagittal and frontal plane. Orthopaedic Journal of Sports Medicine. 2016; 4: 232596711665515.

[35] Powers CM. The influence of abnormal hip mechanics on knee injury: a biomechanical perspective. Journal of Orthopaedic & Sports Physical Therapy. 2010; 40: 42–51.

[36] Herrington L, Wrapson C, Matthews M, Matthews H. Anterior cruciate ligament reconstruction, hamstring versus bone–patella tendon–bone grafts: a systematic literature review of outcome from surgery. The Knee. 2005; 12: 41–50.

[37] Makihara Y, Nishino A, Fukubayashi T, Kanamori A. Decrease of knee flexion torque in patients with ACL reconstruction: combined analysis of the architecture and function of the knee flexor muscles. Knee Surgery, Sports Traumatology, Arthroscopy. 2006; 14: 310–317.

[38] Kim JG, Yang SJ, Lee YS, Shim JC, Ra HJ, Choi JY. The effects of hamstring harvesting on outcomes in anterior cruciate ligament–reconstructed patients: a comparative study between hamstring-harvested and -unharvested patients. Arthroscopy: The Journal of Arthroscopic & Related Surgery. 2011; 27: 1226–1234.

[39] Yosmaoglu HB, Baltaci G, Ozer H, Atay A. Effects of additional gracilis tendon harvest on muscle torque, motor coordination, and knee laxity in ACL reconstruction. Knee Surgery, Sports Traumatology, Arthroscopy. 2011; 19: 1287–1292.


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