Quadriceps strength, patellar tendon quality, relative load exposure, and knee symptoms in male athletes before the anterior cruciate ligament reconstruction

IntroductionAnterior cruciate ligament (ACL) injuries cause knee instability, knee pain, weight-bearing adjustments, and functional deficits but their association to patellar tendon quality is unknown. Our purpose was to investigate quadriceps strength, patellar tendon quality, relative load exposur...

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Main Authors: Carla S. Pereira, Jasenko Klauznicer, Dustin Maree, Sean McAuliffe, Abdulaziz Farooq, Rod Whiteley, Taija Finni
Format: Article
Language:English
Published: Frontiers Media S.A. 2023-10-01
Series:Frontiers in Rehabilitation Sciences
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fresc.2023.1283635/full
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author Carla S. Pereira
Carla S. Pereira
Jasenko Klauznicer
Dustin Maree
Sean McAuliffe
Abdulaziz Farooq
Rod Whiteley
Taija Finni
author_facet Carla S. Pereira
Carla S. Pereira
Jasenko Klauznicer
Dustin Maree
Sean McAuliffe
Abdulaziz Farooq
Rod Whiteley
Taija Finni
author_sort Carla S. Pereira
collection DOAJ
description IntroductionAnterior cruciate ligament (ACL) injuries cause knee instability, knee pain, weight-bearing adjustments, and functional deficits but their association to patellar tendon quality is unknown. Our purpose was to investigate quadriceps strength, patellar tendon quality, relative load exposure, perceived knee stability, knee pain, extension angle, and time from ACL injury; in addition to examining their relative associations.MethodsInjured and uninjured legs of 81 male athletes of different sports with a unilateral ACL injury (18–45 years) were examined. Participants reported location and intensity of knee pain and their perceived stability using a numerical rating scale (NRS 0–10). Strength was tested with an isokinetic device. Tendon quality was measured using ultrasound tissue characterization. Means ± standard deviation (SD) of perceived knee stability, knee extension angle, knee pain, isokinetic quadriceps strength in relation to body mass, proportion of echo-types (I–IV), tendon volume, and number of days from ACL injury to assessment are reported. Values of effect sizes (ES) and correlations (rs) were calculated.ResultsACL injured leg demonstrated reduced reported knee stability (6.3 ± 2.5), decreased knee extension angle (−0.7 ± 3.1° vs. −2.7 ± 2.2°; ES = 0.7; P < 0.001), greater knee pain (NRS 3.1 ± 2.2 vs. 0.0 ± 0.1; ES = 2.0; P < 0.001), and 22% lower quadriceps strength (228.0 ± 65.0 vs. 291.2 ± 52.9 Nm/kg: ES = 1.2; P < 0.001) as compared to the uninjured leg. However, patellar tendons in both legs displayed similar quality. Quadriceps strength was associated with stability (rs = −0.54; P < 0.001), pain (rs = −0.47; P < 0.001), extension angle (rs = −0.39; P < 0.001), and relative load exposure (rs = −0.34; P < 0.004). Echo-types distribution was beneficially associated with time from ACL injury (rs range: −0.20/ −0.32; P < 0.05).DiscussionACL injured athletes displayed knee pain, extension deficit, and weaker quadriceps in the injured leg. While there were no differences in patellar tendon quality between legs, longer time from ACL injury showed better tendon quality.
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spelling doaj.art-1ab7a96d9b444eda82bd3179b88e77812023-10-20T15:19:43ZengFrontiers Media S.A.Frontiers in Rehabilitation Sciences2673-68612023-10-01410.3389/fresc.2023.12836351283635Quadriceps strength, patellar tendon quality, relative load exposure, and knee symptoms in male athletes before the anterior cruciate ligament reconstructionCarla S. Pereira0Carla S. Pereira1Jasenko Klauznicer2Dustin Maree3Sean McAuliffe4Abdulaziz Farooq5Rod Whiteley6Taija Finni7Rehabilitation Department, ASPETAR, Orthopaedic and Sports Medicine Hospital, FIFA Medical Centre of Excellence, Doha, QatarNeuromuscular Research Center, Biology of PhysicalActivity, Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, FinlandRehabilitation Department, ASPETAR, Orthopaedic and Sports Medicine Hospital, FIFA Medical Centre of Excellence, Doha, QatarRehabilitation Department, ASPETAR, Orthopaedic and Sports Medicine Hospital, FIFA Medical Centre of Excellence, Doha, QatarDepartment of Physical Therapy & Rehabilitation Science, College of Health Sciences, Qatar University, Doha, QatarRehabilitation Department, ASPETAR, Orthopaedic and Sports Medicine Hospital, FIFA Medical Centre of Excellence, Doha, QatarRehabilitation Department, ASPETAR, Orthopaedic and Sports Medicine Hospital, FIFA Medical Centre of Excellence, Doha, QatarNeuromuscular Research Center, Biology of PhysicalActivity, Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, FinlandIntroductionAnterior cruciate ligament (ACL) injuries cause knee instability, knee pain, weight-bearing adjustments, and functional deficits but their association to patellar tendon quality is unknown. Our purpose was to investigate quadriceps strength, patellar tendon quality, relative load exposure, perceived knee stability, knee pain, extension angle, and time from ACL injury; in addition to examining their relative associations.MethodsInjured and uninjured legs of 81 male athletes of different sports with a unilateral ACL injury (18–45 years) were examined. Participants reported location and intensity of knee pain and their perceived stability using a numerical rating scale (NRS 0–10). Strength was tested with an isokinetic device. Tendon quality was measured using ultrasound tissue characterization. Means ± standard deviation (SD) of perceived knee stability, knee extension angle, knee pain, isokinetic quadriceps strength in relation to body mass, proportion of echo-types (I–IV), tendon volume, and number of days from ACL injury to assessment are reported. Values of effect sizes (ES) and correlations (rs) were calculated.ResultsACL injured leg demonstrated reduced reported knee stability (6.3 ± 2.5), decreased knee extension angle (−0.7 ± 3.1° vs. −2.7 ± 2.2°; ES = 0.7; P < 0.001), greater knee pain (NRS 3.1 ± 2.2 vs. 0.0 ± 0.1; ES = 2.0; P < 0.001), and 22% lower quadriceps strength (228.0 ± 65.0 vs. 291.2 ± 52.9 Nm/kg: ES = 1.2; P < 0.001) as compared to the uninjured leg. However, patellar tendons in both legs displayed similar quality. Quadriceps strength was associated with stability (rs = −0.54; P < 0.001), pain (rs = −0.47; P < 0.001), extension angle (rs = −0.39; P < 0.001), and relative load exposure (rs = −0.34; P < 0.004). Echo-types distribution was beneficially associated with time from ACL injury (rs range: −0.20/ −0.32; P < 0.05).DiscussionACL injured athletes displayed knee pain, extension deficit, and weaker quadriceps in the injured leg. While there were no differences in patellar tendon quality between legs, longer time from ACL injury showed better tendon quality.https://www.frontiersin.org/articles/10.3389/fresc.2023.1283635/fullACLkneequadricepsisokineticultrasound tissue characterizationpatellar tendon
spellingShingle Carla S. Pereira
Carla S. Pereira
Jasenko Klauznicer
Dustin Maree
Sean McAuliffe
Abdulaziz Farooq
Rod Whiteley
Taija Finni
Quadriceps strength, patellar tendon quality, relative load exposure, and knee symptoms in male athletes before the anterior cruciate ligament reconstruction
Frontiers in Rehabilitation Sciences
ACL
knee
quadriceps
isokinetic
ultrasound tissue characterization
patellar tendon
title Quadriceps strength, patellar tendon quality, relative load exposure, and knee symptoms in male athletes before the anterior cruciate ligament reconstruction
title_full Quadriceps strength, patellar tendon quality, relative load exposure, and knee symptoms in male athletes before the anterior cruciate ligament reconstruction
title_fullStr Quadriceps strength, patellar tendon quality, relative load exposure, and knee symptoms in male athletes before the anterior cruciate ligament reconstruction
title_full_unstemmed Quadriceps strength, patellar tendon quality, relative load exposure, and knee symptoms in male athletes before the anterior cruciate ligament reconstruction
title_short Quadriceps strength, patellar tendon quality, relative load exposure, and knee symptoms in male athletes before the anterior cruciate ligament reconstruction
title_sort quadriceps strength patellar tendon quality relative load exposure and knee symptoms in male athletes before the anterior cruciate ligament reconstruction
topic ACL
knee
quadriceps
isokinetic
ultrasound tissue characterization
patellar tendon
url https://www.frontiersin.org/articles/10.3389/fresc.2023.1283635/full
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