ACL-Reconstruction Autografts, Musculotendinous Stiffness, and Knee Osteoarthritis

athletic therapy today © 2010 Human Kinetics ATT 15(2), pp. 32-38 FUNCTIONAL KNEE stability primarily depends on the stiffness of the musculoskeletal tissues spanning the joint.1,2 Musculotendinous stiffness (MTS) attenuates joint perturbations encountered during the execution of functional tasks, such as ambulation and jump landing.1,3 The attenuation of joint perturbations prevents excessive joint displacement and modifies the loads that would otherwise be imposed on the anatomic structures of the knee.1-4 B a s i c s c i e n c e exper iments have yielded conflicting data concerning donor-site MTS response to autograft tissue harvest.5-8 The defect created by harvesting of the bone-patellar tendonbone (BPTB) autograft for anterior cruciate ligament reconstruction (ACL-R) has been hypothesized to decrease patellar tendon stiffness and to contribute to joint degeneration.9 Interestingly, a greater incidence of knee osteoarthritis (OA) has been reported for BPTB ACL-R compared to utilization of a semitendinosus and gracilis (STG) autograft.10-12 This difference suggests that the STG ACL-R autograft may better preserve joint health.13 The purpose of this report is to provide athletic trainers and therapists with a synopsis of the literature pertaining to MTS response following ACL-R surgery. Possible mechanisms for the discrepancy in the incidence of knee OA following BPTB and STG ACL-R will be presented.