Tale of quadriceps and hamstring muscle strength after ACL reconstruction: a systematic review with longitudinal and multivariate meta-analysis.

Autor:	Girdwood M; La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Victoria, Australia., Culvenor AG; La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Victoria, Australia., Rio EK; La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Victoria, Australia.; The Australian Ballet, Southbank, Victoria, Australia.; The Victorian Institute of Sport, Melbourne, Victoria, Australia., Patterson BE; La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Victoria, Australia., Haberfield M; La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Victoria, Australia., Couch J; La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Victoria, Australia.; Arthritis Research Canada, Vancouver, British Columbia, Canada., Mentiplay B; La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Victoria, Australia.; Sport, Performance, and Nutrition Research Group, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Victoria, Australia., Hedger M; La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Victoria, Australia., Crossley KM; La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Victoria, Australia k.crossley@latrobe.edu.au.
Jazyk:	angličtina
Zdroj:	British journal of sports medicine [Br J Sports Med] 2024 Oct 10. Date of Electronic Publication: 2024 Oct 10.
DOI:	10.1136/bjsports-2023-107977
Abstrakt:	Objective: This study aimed to investigate how knee extensor and flexor strength change over time after anterior cruciate ligament reconstruction (ACLR). Design: Systematic review with longitudinal meta-analysis. Data Sources: Medline, Embase, CINAHL, Scopus, Cochrane CENTRAL and SPORTDiscus to 28 February 2023. Eligibility Criteria: Studies of primary ACLR (n≥50), with mean participant age 18-40 years, reporting a quantitative measure of knee extensor or flexor strength were eligible. Muscle strength had to be reported for the ACL limb and compared with: (1) the contralateral limb (within-person); and/or (2) an uninjured control limb (between-person). Results: We included 232 studies of 34 220 participants. Knee extensor and flexor strength showed sharp initial improvement postoperatively before tailing off at approximately 12-18 months post surgery with minimal change thereafter. Knee extensor strength was reduced by more than 10% compared with the contralateral limb and approximately 20% compared with uninjured controls at 1 year for slow concentric, fast concentric and isometric contractions. Knee flexor strength showed smaller deficits but was still 5%-7% lower than the contralateral limb at 1 year for slow concentric, fast concentric and isometric contractions. Between-person comparisons showed larger deficits than within-person comparisons. Conclusion: Knee extensor muscle strength is meaningfully reduced (>10%) at 1 year, with limited improvement after this time up to and beyond 5 years post surgery. Many people likely experience persistent and potentially long-term strength deficits after ACLR. Comparison within person (to the contralateral limb) likely underestimates strength deficits in contrast to uninjured controls. Competing Interests: Competing interests: KMC holds a research grant from Levin Health. BP, AGC and EKR are Associate Editors at the British Journal of Sports Medicine. KMC is a Senior Advisor to the British Journal of Sports Medicine. (© Author(s) (or their employer(s)) 2024. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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