Biomechanical asymmetries differ between autograft types during unplanned change of direction after ACL reconstruction

Miles, Joshua, McGuigan, Polly, King, Enda and Daniels, Katherine AJ (2022) Biomechanical asymmetries differ between autograft types during unplanned change of direction after ACL reconstruction. Scandinavian Journal of Medicine and Science in Sports, 32 (8). pp. 1236-1248. ISSN 0905-7188

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Official URL: https://doi.org/10.1111/sms.14166

Abstract

Nine months after anterior cruciate ligament (ACL) reconstruction, athletes who undergo surgery using a bone-patellar-tendon-bone (BPTB) autograft demonstrate higher loading asymmetries during vertical jumping than those with a hamstring tendon (HT) autograft. These asymmetries may transfer into sporting movements with a greater ACL injury risk. The aim of this study was to compare between-limb asymmetries in knee mechanics and task performance during an unplanned 90° change-of-direction (CoD) task in male field sport athletes reconstructed with BPTB or HT autografts. Seventy-eight male multidirectional field sport athletes with either a BPTB (n=39) or HT (n=39) autograft completed maximal unplanned CoD trials in a three-dimensional motion capture laboratory at approximately nine months post-surgery. A mixed model 2x2 ANOVA (autograft type x limb) was used to compare variables related to ACL injury risk (e.g. internal knee moments) and performance (e.g. completion time) between autografts and limbs. Statistical parametric mapping was used for a waveform comparison throughout stance, supplemented with a discrete point analyses of peak knee moments and performance variables. Interaction effects were found at the knee joint, with BPTB demonstrating greater asymmetries than HT in knee extension moment (p<0.001); resultant ground reaction force (p<0.001); peak knee external rotation moment (p=0.04); and knee adduction (p=0.05), medial rotation (p<0.001) and flexion (p<0.001) angles. No differences were found between autografts for any performance variable. BPTB demonstrated greater lower-limb biomechanical asymmetries than HT during CoD, which may influence knee loading and longer-term outcomes and should thus be targeted during rehabilitation prior to return to play.

Item Type:	Article
Peer-reviewed:	Yes
Date Deposited:	20 Apr 2022 09:03
Publisher:	Wiley
Additional Information:	This is the peer reviewed version of the following article: Miles, J., McGuigan, P., King, E. and Daniels, K. (2022), Biomechanical asymmetries differ between autograft types during unplanned change of direction after ACL reconstruction. Scandinavian Journal of Medicine & Science in Sports, which has been published in final form at https://doi.org/10.1111/sms.14166. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions. This article may not be enhanced, enriched or otherwise transformed into a derivative work, without express permission from Wiley or by statutory rights under applicable legislation. Copyright notices must not be removed, obscured or modified. The article must be linked to Wiley’s version of record on Wiley Online Library and any embedding, framing or otherwise making available the article or pages thereof by third parties from platforms, services and websites other than Wiley Online Library must be prohibited.
Divisions:	Faculties > Science and Engineering
Subject terms:	Science & Technology, Life Sciences & Biomedicine, Sport Sciences, anterior cruciate ligament, asymmetry, bone-patellar tendon-bone autograft, hamstring autograft, rehabilitation, statistical parametric mapping, CRUCIATE LIGAMENT RECONSTRUCTION, LIMB SYMMETRY INDEXES, FEMALE SOCCER PLAYERS, KNEE MECHANICS, RISK-FACTORS, HOP TESTS, ANTERIOR, INJURY, STRENGTH, PERSIST, Patellar Ligament, Knee Joint, Humans, Transplantation, Autologous, Male, Anterior Cruciate Ligament Reconstruction, Autografts, Anterior Cruciate Ligament Injuries, Hamstring Tendons, anterior cruciate ligament, asymmetry, bone-patellar tendon-bone autograft, hamstring autograft, rehabilitation, statistical parametric mapping, Anterior Cruciate Ligament Injuries, Anterior Cruciate Ligament Reconstruction, Autografts, Hamstring Tendons, Humans, Knee Joint, Male, Patellar Ligament, Transplantation, Autologous, 1106 Human Movement and Sports Sciences, 1116 Medical Physiology, Sport Sciences
URI:	https://e-space.mmu.ac.uk/id/eprint/629584
DOI:	https://doi.org/10.1111/sms.14166
ISSN	0905-7188
e-ISSN	1600-0838

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