Does ACL reconstruction with hamstring tendon autograft predisposes to a knee valgus alignment on initial contact during landing? A drop vertical jump movement analysis

Abstract

Objectives: The mechanism most correlated to anterior cruciate ligament tears is the simultaneous valgus and external rotation of the knee. This study investigated if ACL reconstruction with hamstring tendon autograft predisposes to a "knee-in & toe-out" compared to ACL reconstruction with patellar tendon autograft and to healthy individuals during a drop vertical jump. Methods: A three-dimensional markerless motion capture was used to conduct a case control study, collecting data from 11 healthy participants and 14 participants who underwent ACL reconstruction, 8 with hamstring tendon autograft and 6 with patellar tendon autograft, while performing bilateral drop vertical jump. Joint kinematic variables such as angular positions, moments and velocities were obtained by processing video recordings with Theia Markerless system and Visual3D. Differences between groups were calculated using independent Sample T-test and One-Way ANOVA with Bonferroni post hoc adjustments. Results: No significant differences were found at peak knee valgus for maximum valgus (mean difference (md): -2.14 ± 1.57 deg, p=0,187), rotation (md: 1.04 ± 1.97 deg, p=0.601) and flexion (md: -10.29 ± 11.82 deg, p=0.393) of the knee, when comparing healthy participants with those who underwent ACL reconstruction. Vertical ground reaction forces were significantly higher in the healthy group when compared to the ACL reconstruction group (md: 0.04 ± 0.02 N, p=0.034). Knee extension angular moment and angular velocity were significantly higher on the healthy participants, when compared to participants who underwent ACL reconstruction with patellar tendon autograft (md: 0.65 ± 0.18 Nm/kg, p=0.004; md: -111.51 ± 38.31 deg/s, p=0.024, respectively). Conclusion: ACL reconstruction with hamstring tendon autograft doesn´t increase the risk of a valgus knee alignment movement on initial contact during landing. Differences found in various parameters may justify the evaluation of the quality movement with a motion capture system while performing the drop vertical jump for the creation of specialized rehabilitation programs.