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Comparison of Functional Outcome Measures After ACL Reconstruction in Competitive Soccer Players: A Randomized Trial

Mohammadi, Farshid PhD; Salavati, Mahyar PhD; Akhbari, Behnam PhD; Mazaheri, Masood PhD; Mohsen Mir, Seyed MSc; Etemadi, Yasaman MSc

Journal of Bone & Joint Surgery - American Volume: 17 July 2013 - Volume 95 - Issue 14 - p 1271–1277
doi: 10.2106/JBJS.L.00724
Scientific Articles

Background: The choice of graft for anterior cruciate ligament (ACL) reconstruction remains controversial. Although many outcome studies comparing bone-patellar tendon-bone and semitendinosus and gracilis tendon grafts have been performed, most have not included tests of functional outcomes that challenge the graft. The objective of the current study was to compare the functional performances of soccer players after ACL reconstruction that was performed with either a bone-patellar tendon-bone or a semitendinosus and gracilis tendon graft.

Methods: Forty-two soccer players with unilateral ACL injury were prospectively randomized to a bone-patellar tendon-bone group (BPTB group; twenty-one subjects) or a semitendinosus and gracilis tendon group (STG group; twenty-one subjects) and followed a rehabilitation protocol. At the time of return to sports, the patients were asked to execute strength, hop, and jump tests and the results were compared between the groups. Twenty-one healthy athletes were recruited as the control group to evaluate their performance of the same tests.

Results: The limbs with the ACL reconstruction in the STG group had greater values for quadriceps torque as well as on the triple-hop, crossover-hop, and jump-landing test (p < 0.01), but the STG and BPTB groups showed similar results in terms of hamstrings peak torque and the results of two other hop tests (p > 0.05). Moreover, the subjects with ACL reconstruction had significantly lower values with regard to quadriceps and hamstrings peak torques and the results of the hop and jump tests compared with the healthy athletes (p < 0.01).

Conclusions: At the time of return to sports, the STG group had better performance in terms of quadriceps strength and the results of the triple-hop, crossover-hop, and jump-landing tests compared with the BPTB group. Compared with controls, soccer players who had undergone ACL reconstruction had less quadriceps and hamstrings strength and inferior hop performance and jump-landing strategy.

Level of Evidence: Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.

1Department of Physical Therapy, University of Social Welfare and Rehabilitation Sciences, Koodakyar Street, Daneshjou Boulevard, Evin, Tehran, Iran. E-mail address:

2Musculoskeletal Research Center, Isfahan University of Medical Sciences, Hezar-Jerib Street, Isfahan, Iran

3School of Rehabilitation, Tehran University of Medical Sciences, Mirdamad, Tehran, Iran

Copyright 2013 by The Journal of Bone and Joint Surgery, Incorporated
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