Comparison of knee loading in subjects 12 weeks post-anterior cruciate ligament reconstruction versus repair when performing a double-limb squat.

BACKGROUND

Despite postoperative complications, anterior cruciate ligament reconstruction remains the gold standard treatment after a tear. Recent advancements in anterior cruciate ligament repair techniques have led to improved outcomes and renewed interest in repair as a less invasive alternative. The purpose of this study was to compare knee biomechanics and quadriceps strength during double-leg squat at 12 weeks between individuals who underwent anterior cruciate ligament reconstruction or repair.

METHODS

A total of 43 participants (21 repair, 23 reconstruction) were included. A 10-camera Motion Capture System was used to capture joint motions during double-leg squat, and two force plates collected ground reaction forces. Peak knee extension moment, knee flexion angle, knee flexion angle displacement, and quadriceps strength were measured. Independent t-tests were performed for participant demographics (age, height, mass), International Knee Documentation Committee Subjective Knee Evaluation Form scores, and isokinetic quadriceps strength. A univariate ANCOVA was performed on each dependent variable and Cohen's d effect size was calculated.

FINDINGS: The repair group demonstrated significantly greater knee extension moment compared to the reconstruction group after accounting for age (P = .033, effect size = 1.00). No statistically significant differences were observed between groups for quadriceps strength (P = .138), peak knee flexion angle (P = .330), or knee flexion angle displacement (P = .372).

INTERPRETATION: This study adds to the growing body of literature demonstrating favorable outcomes of repair compared to reconstruction. In addition to previously identified advantages of repair, there appears to be some biomechanical advantage of repair compared to reconstruction at 12 weeks.