Anterior Cruciate Ligament Reconstruction with Hamstring Tendons Has no Deleterious Effect on Hip Extension Strength

Background: Hamstring tendons are secondary hip extensors. Their harvest for graft in anterior cruciate ligament(ACL) reconstruction may create deleterious effect on hip extension strength. This is of particular importance in sportsthat need powerful hip extension force like climbing and sprinting. Due to scarcity of a comprehensive study in thisarea, we designed this prospective study to evaluate hip extension strength following ACL reconstruction using differenttypes of grafts.Methods: Fifty eight patients were enrolled in this prospective non-randomized case control study to compareisokinetic hip extension strength following ACL reconstruction with different graft types. Twenty patients in groupA (both Semitendinosus and Gracilis tendons autograft (ST-G)), 14 patients in group B (Tibialis Posterior tendonallograft (Allograft)), 12 patients in group C (bone-patellar tendon-bone autograft (BPTB)) and 12 patients in group D(only semitendinosus autograft (ST)) were studied. Hip extension strength was tested post-operatively at three- andsix-month periods using a Biodex isokinetic testing machine at a speed of 30 degree per second in operated (cases)and non-operated (controls) limbs.Results: There was a significant increase in hip extension force between three and six month intervals in all fourgroups and in both operated (case) and non-operated (control) limbs (P<0.05, 95% CI). However, there was moreincrease in case limbs in comparison to control limbs. There was no significant difference in hip extension strengthamong all four groups (both in case and control limbs) in the third- and the sixth-month post-operative tests.Conclusion: Graft type had no effect on hip extension strength following ACL reconstruction, and the harvest of one orboth hamstrings had no deleterious effect on hip extension force.Level of evidence: III