Table 4

Details outcome studies comparing graft type after ACLR and accelerated, brace-free rehabilitation

StudyHSPTN
(PT-HS)
Follow-upAssessment methodsResults
Beard et al 13 Four-strand ST-GCentral-third45 total1 yearLysholm, Tegner, IKDC, KT-1000, isokinetic muscle strengthNo differences
Clatworthy et al 22 Four-strand ST-GCentral- third38–351 yearIKDC, KT-1000, isokinetic muscle strength, X-rays, MRIHS: mean increase femoral tunnel area was 100.4% compared with decrease of 25% in PT group
HS: mean increase tibial tunnel was 73.9% versus decrease of 2.1% in PT group
No differences clinical findings, knee scores, KT-1000 testing or isokinetic muscle strength
Corry et al 23 Four-strand ST-GCentral- third82–852 yearsLysholm, IKDC, KT-1000, thigh atrophy, kneeling painNo differences: ligament stability, ROM, general symptoms, thigh atrophy at 2 years
PT: more thigh atrophy at 1 year
PT: more kneeling pain
Ejerhed et al 14 Triple or quadruple STCentral- third32–342 yearsLysholm, Tegner, IKDC, KT-1000, single-leg hop test, knee walking testNo differences: Lysholm, Tegner, KT-1000, hop test
PT: worse knee walking test
Engelen et al 30 Four-strand ST-GCentral- third47–502–9 yearsQuestionnaires, isokinetic peak torque and endurance tests, a hop test battery and drop jump including video analysisNo differences: gender, quantity of movement
PT and HS: higher occurrence dynamic knee valgus compared with controls
Feller and Webster15 Four-strand ST-GCentral- third31–343 yearsKneeling pain, Cincinnati knee score, IKDC, KT-1000, return to pre-injury level, isokinetic muscle strengthNo differences: Cincinnati knee score, IKDC, rate return pre-injury activity
PT: more kneeling pain
PT: greater extension deficits
HS: increased knee laxity
Heijne and Werner18 Four-strand ST-GCentral-third34–342 yearsKT-1000, pivot-shift, thigh muscle torque, one-leg hop test, postural sway, anterior knee pain, TegnerNo differences: one-leg hop test, postural sway, ROM
PT: more anterior knee pain
PT: earlier return to sports and higher level
HS: increased knee laxity and pivot shift
HS: less quadriceps-hamstring strength ratio
Laoruengthana et al 19 Six-strand STCentral-third15–1319 monthsKT-2000, IKDC, LysholmPT: more anterior knee pain
PT: increased knee laxity
HS: higher return to sports
Mohammadi et al 20 Four-strand ST-GCentral-third21–218 monthsIsokinetic strength, single, triple and crossover hop tests, jump landingHS: better quadriceps strength, triple hop test, crossover hop, jump landing
Pinczewski et al 24 Four-strand ST-GCentral-third89–755 yearsIKDC, Lysholm, KT-1000, thigh atrophy, kneeling pain, weight-bearing radiographsNo differences: knee stability, complications
PT: more osteoarthritis
Pinczewski et al 28 Four-strand ST-GCentral-third53–5810 yearsIKDC, Lysholm, KT-1000, thigh atrophy, kneeling pain, weight-bearing radiographsNo differences: graft rupture, clinical outcome
PT: more harvest site symptoms and osteoarthritis
Rudroff25 Four-strand ST-GCentral-third15–152 yearsThigh circumference, maximal isometric strength, two- and one-leg hop tests, squat and gait analysis (EMG data)PT: decreased functional performance, decreased less flexion knee during jumps, lower activation of quadriceps and hamstring muscles, increased gait asymmetry
Witvrouw et al 27 Four-strand ST-GCentral-third17–321 yearThigh atrophy, ROM, swelling, KT-1000, isokinetic muscle strength, Lysholm, Tegner, Kujala scoreNo differences: quadriceps strength, functional scores, ROM, swelling
HS: increased knee laxity
HS: decreased isokinetic peak strength
  • EMG, electromyographic; G, gracilis tendon; HS, hamstring autograft; PT, patellar tendon autograft; ROM, range of motion; ST, semitendinosus tendon.