Background:There is limited evidence related to the effects of autograft type on functional performance after anterior cruciate ligament reconstruction (ACLR).Purpose/Hypothesis:This study aimed to compare biomechanical outcomes during a drop vertical jump (DVJ) between patients with a hamstring tendon (HT) autograft, quadriceps tendon (QT) autograft with bone block, QT autograft without bone block, and bone–patellar tendon–bone autograft at 6 months postoperatively in an adolescent population. The authors’ hypothesized there would be differences in DVJ biomechanics between athletes depending on the type of autograft used.Study Design:Controlled laboratory study.Methods:Patients aged 8 to 18 years who underwent primary ACLR were included for analysis. Kinematic and kinetic data collected during a DVJ using a 3-dimensional computerized marker system were assessed at 6 months after ACLR and compared with the uninjured contralateral limb.Results:A total of 155 participants were included. There were no significant differences in terms of age, sex, or affected leg ( P≥ .1973) between groups. The HT group was significantly associated with a larger knee valgus moment at initial contact compared with the QT group (28 × 10–2 vs −35 × 10–2 N·m/kg, respectively; P = .0254) and a significantly larger maximum hip adduction moment compared with the QT with bone block group (30 × 10–2 vs −4 × 10–2 N·m/kg, respectively; P = .0426). Both the QT with bone block (–12 × 10–2 vs −3 × 10–2 N·m/kg, respectively; P = .0265) and QT (–13 × 10–2 vs −3 × 10–2 N·m/kg, respectively; P = .0459) groups demonstrated significantly decreased mean knee extension moments compared with the HT group.Conclusion:The findings of this study suggest that utilizing an HT autograft resulted in a significantly increased knee valgus moment at initial contact compared with a QT autograft without bone block at 6 months after ACLR in adolescent patients performing a DVJ. A QT autograft was found to be associated with significantly decreased extensor mechanism function compared with an HT autograft.Clinical Relevance:This study adds unique kinematic and kinetic information regarding various ACLR autograft options and highlights the biomechanical deficits that should be taken into consideration in rehabilitation.

中文翻译：

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自体腘绳肌腱与前十字韧带重建后膝外翻增加有关：生物力学分析

背景：关于自体移植物类型对前交叉韧带重建 (ACLR) 后功能表现的影响的证据有限。目的/假设：本研究旨在比较腘绳肌腱患者在垂直跳跃 (DVJ) 过程中的生物力学结果青少年人群术后 6 个月的自体股四头肌腱 (HT) 移植物、带骨块的自体股四头肌腱 (QT) 移植物、不带骨块的 QT 自体移植物以及骨-髌腱-骨自体移植物。作者假设，根据所使用的自体移植物的类型，运动员之间的 DVJ 生物力学会存在差异。研究设计：对照实验室研究。方法：纳入接受初次 ACLR 的 8 至 18 岁患者进行分析。在 ACLR 后 6 个月评估使用 3 维计算机标记系统在 DVJ 期间收集的运动学和动力学数据，并与未受伤的对侧肢体进行比较。结果：总共纳入了 155 名参与者。各组之间的年龄、性别或受影响的腿（P≥.1973）没有显着差异。与 QT 组相比，HT 组在初始接触时与更大的膝外翻力矩显着相关（28 × 10–2vs -35 × 10–2分别为N·m/kg；P = .0254) 和与骨块 QT 组 (30 × 10–2vs -4 × 10–2分别为N·m/kg；P = .0426)。骨块 QT (–12 × 10–2vs -3 × 10–2分别为N·m/kg；P = .0265) 和 QT (–13 × 10–2vs -3 × 10–2分别为N·m/kg；P = .0459) 与 HT 组相比，各组的平均膝关节伸展力矩显着降低。结论：本研究的结果表明，与无骨 QT 自体移植物相比，使用 HT 自体移植物会导致初始接触时膝关节外翻力矩显着增加进行 DVJ 的青少年患者在 ACLR 后 6 个月进行阻滞。与 HT 自体移植物相比，QT 自体移植物被发现与伸肌机制功能显着下降相关。临床相关性：这项研究增加了有关各种 ACLR 自体移植物选择的独特运动学和动力学信息，并强调了康复中应考虑的生物力学缺陷。