title: The architecture of the ipsilateral quadriceps two years after successful anterior cruciate ligament reconstruction with bone-patellar tendon-bone autograft.
abstract: BACKGROUND
  We undertook a cross-sectional study to evaluate the pennation angle and muscle thickness of the vastus lateralis muscle in patients undergoing unilateral anterior cruciate ligament (ACL) reconstruction with bone-patellar tendon-bone autograft, and compared these values with the contralateral non-operated limb.
  
  
  METHODS
  Twenty three consecutive athletic males who underwent ACL reconstruction using the central third of the patellar ligament were evaluated at 25.9±1.5 months. The International Knee Documentation Committee (IKDC) score was administered, and angles of pennation and muscle thickness were measured by ultrasonography.
  
  
  RESULTS
  There was no significant difference in the pennation angle of the operated leg comparing to the contralateral leg (12.5°±1.81° in the operated leg; 13.25°±2.40° after the test; p=0.117). Quadriceps thickness in the operated leg was significantly decreased in all subjects compared to the contralateral leg (28.4±5.3mm in the operated leg; 32.7±4.85 mm in the contralateral leg; p=0.007).
  
  
  CONCLUSIONS
  Two years after surgery, there is no difference in pennation angle of the vastus lateralis when compared to the contralateral side in patients undergoing unilateral ACL reconstruction with bone-patellar tendon-bone autograft. There is a significant difference in quadriceps muscle thickness, which was less in the operated side on the operated side in all patients. Further studies are required to study the influence of muscle architecture on clinical outcome after ACL reconstruction surgery, and whether there are differences associated with the use of different grafts.
  
  
  METHODS
  Case-control study; level IV.
authors.affiliation: Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University, Via Alvaro del Portillo, 200, Trigoria, 00128 Rome, Italy; CIR (Centro Integrato di Ricerca), Campus Biomedico University, Via Alvaro del Portillo, 21, Trigoria, 00128 Rome, Italy.
authors.forename: Umile Giuseppe
authors.initials: UG
authors.lastname: Longo
authors.affiliation: Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University, Via Alvaro del Portillo, 200, Trigoria, 00128 Rome, Italy; CIR (Centro Integrato di Ricerca), Campus Biomedico University, Via Alvaro del Portillo, 21, Trigoria, 00128 Rome, Italy.
authors.forename: Giacomo
authors.initials: G
authors.lastname: Rizzello
authors.affiliation: Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University, Via Alvaro del Portillo, 200, Trigoria, 00128 Rome, Italy; CIR (Centro Integrato di Ricerca), Campus Biomedico University, Via Alvaro del Portillo, 21, Trigoria, 00128 Rome, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Frnaceschi
authors.affiliation: Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University, Via Alvaro del Portillo, 200, Trigoria, 00128 Rome, Italy; CIR (Centro Integrato di Ricerca), Campus Biomedico University, Via Alvaro del Portillo, 21, Trigoria, 00128 Rome, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Campi
authors.affiliation: Centre for Sports and Exercise Medicine, Barts and The London School of Medicine and Dentistry Mile End Hospital, 275 Bancroft Road, London E1 4DG, England, United Kingdom. Electronic address: n.maffulli@qmul.ac.uk.
authors.forename: Nicola
authors.initials: N
authors.lastname: Maffulli
authors.affiliation: Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University, Via Alvaro del Portillo, 200, Trigoria, 00128 Rome, Italy; CIR (Centro Integrato di Ricerca), Campus Biomedico University, Via Alvaro del Portillo, 21, Trigoria, 00128 Rome, Italy.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Denaro
mesh_terms: D000328:Adult; D059549:Anterior Cruciate Ligament Reconstruction; D050376:Bone-Patellar Tendon-Bone Grafting; D003430:Cross-Sectional Studies; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D017847:Patellar Ligament / Q000637:transplantation; D052097:Quadriceps Muscle / Q000000981:diagnostic imaging*; D014463:Ultrasonography
keywords: Anterior cruciate ligament; Muscle thickness; Pennation angle; Quadriceps; Recovery; Sports