Lower Limb Muscle Size after Anterior Cruciate Ligament Injury: A Systematic Review and Meta-Analysis.


Journal

Sports medicine (Auckland, N.Z.)
ISSN: 1179-2035
Titre abrégé: Sports Med
Pays: New Zealand
ID NLM: 8412297

Informations de publication

Date de publication:
Jun 2021
Historique:
accepted: 20 12 2020
pubmed: 26 1 2021
medline: 28 5 2021
entrez: 25 1 2021
Statut: ppublish

Résumé

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. To systematically review the evidence investigating lower limb muscle size in ACL injured limbs. 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. 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. 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. 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.

Sections du résumé

BACKGROUND 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 OBJECTIVE
To systematically review the evidence investigating lower limb muscle size in ACL injured limbs.
DESIGN METHODS
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 METHODS
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 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 CONCLUSIONS
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.

Identifiants

pubmed: 33492623
doi: 10.1007/s40279-020-01419-0
pii: 10.1007/s40279-020-01419-0
doi:

Types de publication

Meta-Analysis Systematic Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

1209-1226

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Auteurs

Benjamin Dutaillis (B)

School of Behavioural and Health Sciences, Australian Catholic University, 17 Young Street, Fitzroy, VIC, 3065, Australia. benji.dutaillis@outlook.com.

Nirav Maniar (N)

School of Behavioural and Health Sciences, Australian Catholic University, 17 Young Street, Fitzroy, VIC, 3065, Australia.

David A Opar (DA)

School of Behavioural and Health Sciences, Australian Catholic University, 17 Young Street, Fitzroy, VIC, 3065, Australia.
Sports Performance, Recovery, Injury and New Technologies (SPRINT) Research Centre, Australian Catholic University, Fitzroy, VIC, 3065, Australia.

Jack T Hickey (JT)

School of Behavioural and Health Sciences, Australian Catholic University, 17 Young Street, Fitzroy, VIC, 3065, Australia.

Ryan G Timmins (RG)

School of Behavioural and Health Sciences, Australian Catholic University, 17 Young Street, Fitzroy, VIC, 3065, Australia.
Sports Performance, Recovery, Injury and New Technologies (SPRINT) Research Centre, Australian Catholic University, Fitzroy, VIC, 3065, Australia.

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