Benjamin Dutaillis1, Nirav Maniar2, David A Opar2,3, Jack T Hickey2, Ryan G Timmins2,3. 1. School of Behavioural and Health Sciences, Australian Catholic University, 17 Young Street, Fitzroy, VIC, 3065, Australia. benji.dutaillis@outlook.com. 2. School of Behavioural and Health Sciences, Australian Catholic University, 17 Young Street, Fitzroy, VIC, 3065, Australia. 3. Sports Performance, Recovery, Injury and New Technologies (SPRINT) Research Centre, Australian Catholic University, Fitzroy, VIC, 3065, Australia.
Abstract
BACKGROUND: Anterior cruciate ligament (ACL) injury is known to have a number of deleterious effects on lower limb muscle function. Alterations in muscle size are one such effect that have implications towards reductions in strength and functioning of the lower limbs. However, a comprehensive analysis of alterations in muscle size has yet to be undertaken. OBJECTIVE: To systematically review the evidence investigating lower limb muscle size in ACL injured limbs. DESIGN: Systematic review DATA SOURCES: Database searches of Medline, SPORTDiscus, Embase, Cinahl and Web of Science as well as citation tracking and manual reference list searching. ELIGIBILITY CRITERIA FOR SELECTING STUDIES: Individuals with ACL deficient or reconstructed limbs with an assessment of lower limb muscle size and control limb data (contralateral or uninjured control group) METHODS: Risk of bias assessment was completed on included studies. Data were extracted and where possible meta-analyses performed. Best evidence synthesis was also undertaken. RESULTS: 49 articles were included in this review, with 37 articles included in the meta-analyses. 66 separate meta-analyses were performed using various measures of lower limb muscle size. Across all measures, ACL deficient limbs showed lesser quadriceps femoris muscle size (d range = - 0.35 to - 0.40), whereas ACL reconstructed limbs showed lesser muscle size in the quadriceps femoris (d range = - 0.41 to - 0.69), vastus medialis (d = - 0.25), vastus lateralis (d = - 0.31), hamstrings (d = - 0.28), semitendinosus (d range = - 1.02 to - 1.14) and gracilis (d range = - 0.78 to - 0.99) when compared to uninjured limbs. CONCLUSION: This review highlights the effect ACL injury has on lower limb muscle size. Regardless of whether an individual chooses a conservative or surgical approach, the quadriceps of the injured limb appear to have lesser muscle size compared to an uninjured limb. When undertaking reconstructive surgery with a semitendinosus/gracilis tendon graft, the harvested muscle shows lesser muscle size compared to the uninjured limb.
BACKGROUND: Anterior cruciate ligament (ACL) injury is known to have a number of deleterious effects on lower limb muscle function. Alterations in muscle size are one such effect that have implications towards reductions in strength and functioning of the lower limbs. However, a comprehensive analysis of alterations in muscle size has yet to be undertaken. OBJECTIVE: To systematically review the evidence investigating lower limb muscle size in ACL injured limbs. DESIGN: Systematic review DATA SOURCES: Database searches of Medline, SPORTDiscus, Embase, Cinahl and Web of Science as well as citation tracking and manual reference list searching. ELIGIBILITY CRITERIA FOR SELECTING STUDIES: Individuals with ACL deficient or reconstructed limbs with an assessment of lower limb muscle size and control limb data (contralateral or uninjured control group) METHODS: Risk of bias assessment was completed on included studies. Data were extracted and where possible meta-analyses performed. Best evidence synthesis was also undertaken. RESULTS: 49 articles were included in this review, with 37 articles included in the meta-analyses. 66 separate meta-analyses were performed using various measures of lower limb muscle size. Across all measures, ACL deficient limbs showed lesser quadriceps femoris muscle size (d range = - 0.35 to - 0.40), whereas ACL reconstructed limbs showed lesser muscle size in the quadriceps femoris (d range = - 0.41 to - 0.69), vastus medialis (d = - 0.25), vastus lateralis (d = - 0.31), hamstrings (d = - 0.28), semitendinosus (d range = - 1.02 to - 1.14) and gracilis (d range = - 0.78 to - 0.99) when compared to uninjured limbs. CONCLUSION: This review highlights the effect ACL injury has on lower limb muscle size. Regardless of whether an individual chooses a conservative or surgical approach, the quadriceps of the injured limb appear to have lesser muscle size compared to an uninjured limb. When undertaking reconstructive surgery with a semitendinosus/gracilis tendon graft, the harvested muscle shows lesser muscle size compared to the uninjured limb.
Authors: Thomas L Sanders; Hilal Maradit Kremers; Andrew J Bryan; Dirk R Larson; Diane L Dahm; Bruce A Levy; Michael J Stuart; Aaron J Krych Journal: Am J Sports Med Date: 2016-02-26 Impact factor: 6.202
Authors: Timothy W Tourville; Thomas B Voigt; Rebecca H Choquette; Mathew J Failla; Nathan K Endres; James R Slauterbeck; Bruce D Beynnon; Michael J Toth Journal: J Orthop Res Date: 2021-06-20 Impact factor: 3.494