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

Arthroscopy. 2012 Sep;28(9):1262-70. doi: 10.1016/j.arthro.2012.02.014. Epub 2012 May 11.

Abstract

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.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Anterior Cruciate Ligament / surgery
  • Anterior Cruciate Ligament Injuries
  • Anterior Cruciate Ligament Reconstruction*
  • Athletes
  • Bone-Patellar Tendon-Bone Grafting*
  • Electromyography
  • Exercise Test
  • Humans
  • Knee Joint / physiology
  • Knee Joint / physiopathology*
  • Male
  • Muscle, Skeletal / physiopathology*
  • Retrospective Studies
  • Soccer / injuries*
  • Soccer / physiology*
  • Young Adult