Background and Aims Anterior cruciate ligament (ACL) reconstruction in young male athletes is typically performed using various methods, including hamstring tendon autograft (HT), patellar tendon autograft (PT), or allograft (QT). However, no consensus exists on the optimal graft choice for ACL reconstruction. This study aimed to compare the lower limb biomechanics in young male athletes following ACL reconstruction using allograft, patellar tendon autograft, and HT. Methods This study compared the biomechanics of directional changes in young athletes with unilateral ACL reconstruction using HT (n=6), PT (n=6), and QT (n=6). The participants were in the active rehabilitation phase and performed change-of-direction movements (side-step change of direction, forward change of direction, and running with directional change). Biomechanical assessments were conducted using a three-dimensional motion analysis system with eight cameras (Vicon, Vicon Motion Systems Ltd, Oxford, UK) and two analog force plates (AMTI OR6-5, Advanced Medical Terminology, Watertown Inc, MA, USA). Data were analyzed using multivariate analysis of covariance (MANCOVA), which was employed to evaluate intergroup differences in SPSS software, version 26 at a significance level of 0.05. Results MANCOVA revealed a significant difference in vertical ground reaction force (GRF) between the HT, PT, and QT groups (P=0.021), independent of movement direction (P =0.984). Other force variables, such as internal-external and anterior-posterior GRF, loading rate, and hip and knee flexion/extension torques, showed no significant differences between groups or group-direction interactions (P>0.05). However, adduction/abduction and internal/external rotation torques of the hip and knee demonstrated significant dependence on movement direction (P<0.001 and P=0.032). Additionally, hip and knee adduction/abduction and internal/external rotation angles exhibited significant intergroup and directional interactions (P=0.001 and P=0.002 for the hip and P=0.001 for the knee). In contrast, no significant differences were observed in other angles, such as knee flexion/extension and internal/external rotation, across groups or movement directions. Conclusion Overall, the findings indicate reduced knee and hip loading in adolescents following ACL reconstruction. Moreover, athletes with PT or QT grafts experienced greater deficits in knee and hip performance during rehabilitation than with HT grafts. Therefore, graft choice in ACL reconstruction should be tailored to the individual conditions of athletes and planned to optimize movement biomechanics, minimize the risk of graft re-rupture, and reduce complications at the donor site.
Kordi et al. (Tue,) studied this question.