Influence of Graft Type on Muscle Contractile Dynamics After ACL Reconstruction: A 9-Month Tensiomyographic Follow-Up

<b>Background</b>: Persistent neuromuscular deficits following anterior cruciate ligament reconstruction (ACLR) are frequently attributed to arthrogenic muscle inhibition (AMI). The type of autologous graft used may influence the trajectory of neuromuscular recovery. <b>Objective&l...

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Main Authors: Georges Kakavas, Florian Forelli, Yoann Demangeot, Vasileios Korakakis, Nikolaos Malliaropoulos, Nicola Maffulli
Format: Article
Language:English
Published: MDPI AG 2025-07-01
Series:Diagnostics
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Online Access:https://www.mdpi.com/2075-4418/15/15/1920
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author Georges Kakavas
Florian Forelli
Yoann Demangeot
Vasileios Korakakis
Nikolaos Malliaropoulos
Nicola Maffulli
author_facet Georges Kakavas
Florian Forelli
Yoann Demangeot
Vasileios Korakakis
Nikolaos Malliaropoulos
Nicola Maffulli
author_sort Georges Kakavas
collection DOAJ
description <b>Background</b>: Persistent neuromuscular deficits following anterior cruciate ligament reconstruction (ACLR) are frequently attributed to arthrogenic muscle inhibition (AMI). The type of autologous graft used may influence the trajectory of neuromuscular recovery. <b>Objective</b>: To investigate the influence of graft type—bone–patellar tendon–bone (BPTB), hamstring tendon (HT), and quadriceps tendon (QT)—on the contractile properties of periarticular knee muscles over a 9-month post-operative period. <b>Hypothesis</b>: Each graft type would result in distinct recovery patterns of muscle contractility, as measured by tensiomyography (TMG). <b>Methods</b>: Thirty-one patients undergoing ACLR with BPTB (<i>n</i> = 8), HT (<i>n</i> = 12), or QT (<i>n</i> = 11) autografts were evaluated at 3, 6, and 9 months post-operatively. TMG was used to measure contraction time (Tc) and maximal displacement (Dm) in the rectus femoris, vastus medialis, vastus lateralis, and biceps femoris. <b>Results</b>: Significant within-group improvements in Tc and Dm were observed across all graft types from 3 to 9 months (Tc: <i>p</i> < 0.001 to <i>p</i> = 0.02; Dm: <i>p</i> < 0.001 to <i>p</i> = 0.01). The QT group showed the most pronounced Tc reduction in RF (from 30.16 ± 2.4 ms to 15.44 ± 1.6 ms, <i>p</i> < 0.001) and VM (from 31.05 ± 2.6 ms to 18.65 ± 1.8 ms, <i>p</i> = 0.004). In contrast, HT grafts demonstrated limited Tc recovery in BF between 6 and 9 months compared to BPTB and QT (<i>p</i> < 0.001), indicating a stagnation phase. BPTB exhibited persistent bilateral deficits in both quadriceps and BF at 9 months. <b>Conclusions</b>: Autograft type significantly influences neuromuscular recovery patterns after ACLR. TMG enables objective, muscle-specific monitoring of contractile dynamics and may support future individualized rehabilitation strategies.
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spelling doaj-art-85bd2584887342e59950e4d2b6e3c49e2025-08-20T03:35:58ZengMDPI AGDiagnostics2075-44182025-07-011515192010.3390/diagnostics15151920Influence of Graft Type on Muscle Contractile Dynamics After ACL Reconstruction: A 9-Month Tensiomyographic Follow-UpGeorges Kakavas0Florian Forelli1Yoann Demangeot2Vasileios Korakakis3Nikolaos Malliaropoulos4Nicola Maffulli5Fysiotek, Spine and Sports Lab, 11635 Athens, GreeceHaute-Ecole Arc Santé, HES-SO University of Applied Sciences and Arts Western Switzerland, 2000 Neuchâtel, SwitzerlandUniversity of Reims Champagne-Ardenne, MATIM, 51100 Reims, FranceDepartment of Health Sciences, School of Life Sciences and Health Sciences, PhD in Physiotherapy Program, University of Nicosia, Nicosia 2417, CyprusCenter of Orthopaedics and Regenerative Medicine (C.O.RE.)/(C.I.R.I.)—Aristotle University Thessaloniki, 10431 Hellas, GreeceCentre for Sports and Exercise Medicine, Queen Mary University of London, London E1 4NS, UK<b>Background</b>: Persistent neuromuscular deficits following anterior cruciate ligament reconstruction (ACLR) are frequently attributed to arthrogenic muscle inhibition (AMI). The type of autologous graft used may influence the trajectory of neuromuscular recovery. <b>Objective</b>: To investigate the influence of graft type—bone–patellar tendon–bone (BPTB), hamstring tendon (HT), and quadriceps tendon (QT)—on the contractile properties of periarticular knee muscles over a 9-month post-operative period. <b>Hypothesis</b>: Each graft type would result in distinct recovery patterns of muscle contractility, as measured by tensiomyography (TMG). <b>Methods</b>: Thirty-one patients undergoing ACLR with BPTB (<i>n</i> = 8), HT (<i>n</i> = 12), or QT (<i>n</i> = 11) autografts were evaluated at 3, 6, and 9 months post-operatively. TMG was used to measure contraction time (Tc) and maximal displacement (Dm) in the rectus femoris, vastus medialis, vastus lateralis, and biceps femoris. <b>Results</b>: Significant within-group improvements in Tc and Dm were observed across all graft types from 3 to 9 months (Tc: <i>p</i> < 0.001 to <i>p</i> = 0.02; Dm: <i>p</i> < 0.001 to <i>p</i> = 0.01). The QT group showed the most pronounced Tc reduction in RF (from 30.16 ± 2.4 ms to 15.44 ± 1.6 ms, <i>p</i> < 0.001) and VM (from 31.05 ± 2.6 ms to 18.65 ± 1.8 ms, <i>p</i> = 0.004). In contrast, HT grafts demonstrated limited Tc recovery in BF between 6 and 9 months compared to BPTB and QT (<i>p</i> < 0.001), indicating a stagnation phase. BPTB exhibited persistent bilateral deficits in both quadriceps and BF at 9 months. <b>Conclusions</b>: Autograft type significantly influences neuromuscular recovery patterns after ACLR. TMG enables objective, muscle-specific monitoring of contractile dynamics and may support future individualized rehabilitation strategies.https://www.mdpi.com/2075-4418/15/15/1920anterior cruciate ligament reconstructiontensiomyographygraft typemuscle recoveryneuromuscular assessment
spellingShingle Georges Kakavas
Florian Forelli
Yoann Demangeot
Vasileios Korakakis
Nikolaos Malliaropoulos
Nicola Maffulli
Influence of Graft Type on Muscle Contractile Dynamics After ACL Reconstruction: A 9-Month Tensiomyographic Follow-Up
Diagnostics
anterior cruciate ligament reconstruction
tensiomyography
graft type
muscle recovery
neuromuscular assessment
title Influence of Graft Type on Muscle Contractile Dynamics After ACL Reconstruction: A 9-Month Tensiomyographic Follow-Up
title_full Influence of Graft Type on Muscle Contractile Dynamics After ACL Reconstruction: A 9-Month Tensiomyographic Follow-Up
title_fullStr Influence of Graft Type on Muscle Contractile Dynamics After ACL Reconstruction: A 9-Month Tensiomyographic Follow-Up
title_full_unstemmed Influence of Graft Type on Muscle Contractile Dynamics After ACL Reconstruction: A 9-Month Tensiomyographic Follow-Up
title_short Influence of Graft Type on Muscle Contractile Dynamics After ACL Reconstruction: A 9-Month Tensiomyographic Follow-Up
title_sort influence of graft type on muscle contractile dynamics after acl reconstruction a 9 month tensiomyographic follow up
topic anterior cruciate ligament reconstruction
tensiomyography
graft type
muscle recovery
neuromuscular assessment
url https://www.mdpi.com/2075-4418/15/15/1920
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AT yoanndemangeot influenceofgrafttypeonmusclecontractiledynamicsafteraclreconstructiona9monthtensiomyographicfollowup
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