Hamstring Muscle Strength After ACL Hamstring Reconstruction
Condition: Anterior Cruciate Ligament Rupture
MeSH terms: Rupture
Study type: Observational

Summary: 
      Anterior Cruciate Ligament (ACL) reconstructions using hamstring grafts can be performed
      using one or two hamstring grafts, the semitendinosus (ST) tendon only, or both the
      semitendinosus and gracilis (ST/G) tendon. As most patients strive to return to sport nine
      months after reconstruction the purpose of this study was to compare the recovery of
      hamstring muscle strength during these first nine months after reconstruction using the ST or
      ST/G tendons.
    

Detailed description: 
      Anterior cruciate ligament (ACL) reconstruction techniques are developing continuously.
      Studies have shown that anatomical positioning of the femur tunnel is an important predictor
      for the clinical outcome. This has led to the development of new reconstruction techniques
      with a more anatomical placement of the femur tunnel: the anteromedial portal (AMP) ACL
      reconstruction technique and, more recently, the tape locking screw (TLS) ACL reconstruction
      technique. Multiple retrospective studies have shown that patients have a better short term
      clinical outcome when the anteromedial portal (AMP) or the tape locking crew (TLS)
      reconstruction technique is used. At this moment, the most widely used technique is the AMP
      (performed in approximately 80% of the ACL reconstructions). The TLS technique is widely used
      in France and the available literature shows good short-term results.

      A difference between the AMP and the TLS technique is that the AMP technique uses a
      double-bundle hamstring graft where the TLS technique uses a single-bundle hamstring graft.
      The idea is that using a single-bundle hamstring graft causes less hamstring muscle strength
      deficit. The available literature shows different outcomes of hamstring muscle strength
      deficit, although, there are no studies found in which the difference in hamstring muscle
      strength deficit between both techniques directly has been investigated.

      Objective: The main objective of this study is to compare the hamstring muscle strength
      deficit after AMP and TLS reconstruction techniques.

      The primary aim of this study is to investigate if there is a difference in hamstring muscle
      strength deficit at 60°/s flexion in patients with an ACL rupture (18-60 years) who received
      a tape locking screw ACL reconstruction versus patients who received an anteromedial portal
      ACL reconstruction 12 weeks after surgery.

      The secondary aim of this study is to investigate if there is a difference in muscle strength
      deficit at 180°/s and 240°/s flexion and extension 12 weeks after surgery and 60°/s, 180°/s
      and 240°/s flexion and extension 20 weeks after surgery in patients who received a tape
      locking screw ACL reconstruction versus patients who received an anteromedial portal ACL
      reconstruction.
    

Intervention name(s): ACL hamstring reconstructions using semitendinosus (ST) tendon only; ACL hamstring reconstructions using semitendinosus and gracilis (ST/G) tendon
Intervention type(s): Procedure; Procedure
Intervention description(s): ACL reconstruction with a ST tendon graft received a reconstruction according to the Tape Locking Screw technique (FH Industrie, Quimper, France) with a dedicated interference screw; ACL reconstruction with a ST/G tendon graft received a reconstruction with the anteromedial portal technique with endobutton fixation (Smith & Nephew, London, UK).
Observational model: Cohort
Time perspective: Retrospective
Sampling method: Probability Sample
Study population: 
        Patients will be recruited from the Orthopaedic outpatient clinic of the Isala in Zwolle if
        the patient has an ACL rupture and if there is an indication for surgical reconstruction
        with the AMP or TLS ACL reconstruction technique or at the (standard) 6 weeks follow-up
        appointment after AMP or TLS ACL reconstruction surgery