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At least 289 records · Page 16Linked to original sources

PubMed1995

The control of mono-articular muscles in multijoint leg extensions in man.

1. Movements often require control of direction and a magnitude of force exerted externally on the environment. Bi-articular upper leg muscles appear to play a unique role in the regulation of the net torques about the hip and knee joints, necessary for the control of this external force. 2. The aim of this study was to test the hypothesis that the mono-articular muscles act as work generators in powerful dynamic leg extensions, which means that they should be activated primarily in the phases during which they can contribute to work, irrespective of the net joint torques required to control the external force. 3. Cycling movements of six trained subjects were analysed by means of inverse dynamics, yielding net joint torques as well as activity patterns and shortening velocities of four mono- and four bi-articular leg muscles. 4. The results show that the mono-articular muscles exert force only in the phase in which these muscles shorten, whereas this appears not to be the case for the bi-articular muscles. 5. Reciprocal patterns of activation of the rectus femoris and hamstring muscles appear to tune the distribution of net joint torques about the hip and knee joints, necessary to control the (changing) direction of the force on the pedal. 6. An analysis of running in man and additional related literature based on animal studies appears to provide further support for the hypothesis that mono- and bi-articular muscles have essentially different roles in these powerful multijoint leg extension tasks.

Bicycling↗

PubMedDate not supplied

The soleus muscle acts as an agonist for the anterior cruciate ligament. An in vitro experimental study.

BACKGROUND: Although the quadriceps muscles are known antagonists for the anterior cruciate ligament and the hamstring muscles are known agonists, the influence of the calf muscles on knee stability is not well understood. HYPOTHESIS: The soleus muscle acts as an anterior cruciate ligament agonist and the gastrocnemius muscle acts as an anterior cruciate ligament antagonist. STUDY DESIGN: Controlled laboratory study. METHODS: Six cadaveric knees were tested with individual and combined activation of the gastrocnemius and soleus muscles to determine the influence of simulated muscle contraction on tibiofemoral motion. RESULTS: At all flexion angles, applying the soleus muscle force tended to translate the tibia posteriorly, whereas applying the gastrocnemius muscle force tended to translate the tibia anteriorly. Applying the soleus and gastrocnemius muscle forces together also tended to translate the tibia anteriorly. The average anterior and posterior tibial translations were greatest at 50 degrees of flexion. CONCLUSIONS: The soleus muscle is capable of acting as an agonist for the anterior cruciate ligament and the gastrocnemius muscle can act as an antagonist. CLINICAL RELEVANCE: A better understanding of the agonistic behavior of the soleus muscle on the anterior cruciate ligament may lead to the development of training and rehabilitation strategies that could reduce the incidence of injury and improve function in both patients with anterior cruciate ligament deficiency and patients who have undergone anterior cruciate ligament reconstruction.

Aged↗

PubMedDate not supplied

Anterior cruciate ligament reconstruction with multistranded autogenous semitendinosus tendon.

We evaluated 41 knees 24 to 48 months after anterior cruciate ligament reconstruction was performed using multiple autogenous semitendinosus tendons. The ipsilateral free semitendinosus tendon was tripled or quadrupled to make a graft 7 to 10 mm in diameter and more than 60 mm long. When the diameter of the graft was less than 7 mm, an ipsilateral doubled gracilis tendon was also used (in seven cases). Twenty-three patients (56%) returned to their preinjury activity levels. According to the patients' subjective assessment, 34 (83%) graded themselves as normal or nearly normal. No patient reported giving way of the knee or limitation of knee motion. The average anterior laxity difference between the involved knee and contralateral uninjured knee was 1.5 mm at 200 N. Twenty-nine patients (71%) demonstrated an anterior laxity difference of 3 mm or less when the involved knee was compared with the contralateral uninjured knee. Quadriceps muscle strength was 90% compared with the contralateral healthy limb, and hamstring muscle strength was equivalent to the contralateral limb. In our study, tripled or quadrupled semitendinosus free tendons were excellent anterior cruciate ligament grafts for restoring knee stability, recovering thigh muscle power, and preserving knee motion.

Adolescent↗

PubMed1983

Thigh muscle atrophy in below-knee amputees.

The atrophy was evaluated by using muscle biopsies, computed tomography and measuring tape. Ten well functioning below-knee amputees with a mean age of 56 years participated. The amputees had 33 per cent type I fibres in the amputated leg compared to 38 per cent in the non-amputated leg, the difference not being significant. In the amputated leg there was less type IIA fibres (p less than 0.01), more type IIB (p less than 0.05) and type IIC fibres (p less than 0.01) than in the non-amputated leg. Atrophy (single fibres or groups of 4-5 small fibres) of both type I and type II fibres were seen in most patients. The mean muscle fibre area of the vastus lateralis of the amputated leg was 74 per cent of that of the non-amputated leg (p less than 0.05). In both legs the area of type II fibres was larger than that of type I fibres. The cross-sectional area of the whole thigh in the amputated leg was 86 per cent (p less than 0.05), of the quadriceps muscles 66 per cent (p less than 0.01) and of the hamstring muscles 80 per cent (p less than 0.05) of the area of the non-amputated leg. It was not possible to demonstrate if there was a reduction in the total number of muscle fibres. This indicates that the main cause for the reduction of muscle volume is the reduction in fibre sizes. There was no significant difference in circumference measurements when using computed tomography or measuring tape.

Adult↗

PubMed1992

Differential muscle strength decline in osteoarthritis of the knee. A developing hypothesis.

The ratio of quadriceps to hamstrings muscle strength (Q/H ratio) is important for the stability of the knee and for protection from excessive stress. The purpose of this study was to explore whether the Q/H ratio is altered in patients with osteoarthritis (OA). Subjects were 43 patients with physician-diagnosed OA of the knee (mean age, 65.61 years; SD, 12.74). Isometric knee flexor and extensor strength was measured with a hand-held dynamometer. Both muscle groups were weak, with relatively greater weakness in the quadriceps muscles. The mean Q/H ratio of 1.43 (SD, 0.39) was below ratios reported for young healthy adults (2.0). The low Q/H ratio might be caused by the inability to correct the measurement for gravity, but a liberal estimate of gravity correction raised the ratio only to 1.71 (SD, 0.47). The low Q/H ratio was probably not caused by physiologic changes due to aging, because the correlation between the ratio and age was low (-0.04). Since the correlation of the Q/H ratio with the usual level of pain (measured by a visual analogue scale) was negative (-0.26), the low ratio might be explained by reflex inhibition due to pain associated with disease.

Adult↗

PubMed2003

Hamstring injury occurrence in elite soccer players after preseason strength training with eccentric overload.

The primary purpose of this study was to evaluate whether a preseason strength training programme for the hamstring muscle group - emphasising eccentric overloading - could affect the occurrence and severity of hamstring injuries during the subsequent competition season in elite male soccer players. Thirty players from two of the best premier-league division teams in Sweden were divided into two groups; one group received additional specific hamstring training, whereas the other did not. The extra training was performed 1-2 times a week for 10 weeks by using a special device aiming at specific eccentric overloading of the hamstrings. Isokinetic hamstring strength and maximal running speed were measured in both groups before and after the training period and all hamstring injuries were registered during the total observational period of 10 months. The results showed that the occurrence of hamstring strain injuries was clearly lower in the training group (3/15) than in the control group (10/15). In addition, there were significant increases in strength and speed in the training group. However, there were no obvious coupling between performance parameters and injury occurrence. These results indicate that addition of specific preseason strength training for the hamstrings - including eccentric overloading - would be beneficial for elite soccer players, both from an injury prevention and from performance enhancement point of view.

Adult↗

PubMed2006

Complete semimembranosus rupture following therapeutic stretching after a traumatic brain injury.

Acute hamstring rupture is an uncommon event often occurring during high impact sports. Such events have not been previously reported during neurological rehabilitation. This case report describes a 30 year-old Chinese male presenting in a minimally responsive state 5 years after a severe traumatic brain injury. He was tetraplegic and bed-bound with spasticity involving all four limbs and flexion contracture of the right knee. During an episode of inpatient rehabilitation, he developed acute swelling and bruising of the posterior proximal thigh region associated with fever, tachycardia and diaphoresis. MRI showed a large soft tissue rim-enhancing mass in the right proximal hamstring muscle. During surgical exploration, complete rupture of the right semi-membranosus muscle was found without evidence of pus. The possible causative factors of hamstring rupture in this subject and a brief literature review are discussed. To the authors' knowledge, this is the first such reported case.

Acute Disease↗

PubMed1996

Assessment of exercise-induced minor muscle lesions: the accuracy of Cyriax's diagnosis by selective tension paradigm.

The Cyriax selective tension assessment paradigm is commonly used by clinicians for the diagnosis of soft tissue lesions; however, studies have not demonstrated that it is a valid method. The purpose of this study was to examine the construct validity of the active motion, passive motion, resisted movement, and palpation components of the Cyriax selective tension diagnosis paradigm in subjects with an exercise-induced minor hamstring muscle lesion. Nine female subjects with a mean age of 23.6 years (SD = 4.7) and a mass of 57.3 kg (SD = 10.7) performed two sets of 20 maximal eccentric isokinetic knee flexor contractions designed to induce a minor muscle lesion of the hamstrings. Active range of motion, passive range of motion, knee extension end-feel pain relative to resistance sequence, knee flexor isometric strength, pain perception during knee flexor resisted movement testing, and palpation pain of the hamstrings were assessed at 0, 5, 2, 12, 24, 48, and 72 hours postexercise and compared with Cyriax's hypothesized selective tension paradigm results. Consistent with Cyriax's paradigm, passive range of motion remained unchanged, and perceived pain of the hamstrings increased with resistance testing at 12, 24, 48, and 72 hours postexercise when compared with baseline. In addition, palpation pain of the hamstrings was significantly elevated at 48 and 72 hours after exercise (p < 0.05). In contrast of Cyriax's paradigm, active range of motion was significantly reduced over time (p < 0.05), with the least amount of motion compared to baseline (85%) occurring at 48 hours postexercise. Further, resisted movement testing found significant knee flexor isometric strength reductions over time (p < 0.05), with the greatest reductions (33%) occurring at 48 hours postexercise. According to Cyriax, when a minor muscle lesion is tested, it should be strong and painful; however, none of the postexercise time frames exhibited results that were strong and painful. This study suggests that the validity of using Cyriax's selective tension testing for the diagnosis of exercise-induced minor muscle lesions is questionable.

Adult↗

PubMed2004

A comparison of 2 rehabilitation programs in the treatment of acute hamstring strains.

STUDY DESIGN: Prospective randomized comparison of 2 rehabilitation programs. OBJECTIVES: The objectives of this study were to compare the effectiveness of 2 rehabilitation programs for acute hamstring strain by evaluating time needed to return to sports and reinjury rate during the first 2 weeks and the first year after return to sport. A third objective was to investigate the relationship between functional testing performance and time to return to sports and reinjury rates after return to sport. BACKGROUND: Hamstring muscle strains are common in sports and often result in chronic pain, recurrent hamstring strains, and reduced sports performance. Current rehabilitation programs are primarily developed anecdotally and lack support from prospective, randomized research. METHODS AND MEASURES: Twenty-four athletes with an acute hamstring strain were randomly assigned to 1 of 2 rehabilitation groups. Eleven athletes were assigned to a protocol consisting of static stretching, isolated progressive hamstring resistance exercise, and icing (STST group). Thirteen athletes were assigned to a program consisting of progressive agility and trunk stabilization exercises and icing (PATS group). The number of days for full return to sports, injury recurrence within the first 2 weeks, injury recurrence within the first year of returning to sports, and lower-extremity functional evaluations were collected for all subjects and compared between groups. RESULTS: The average (+/- SD) time required to return to sports for athletes in the STST group was 37.4 +/- 27.6 days, while the average time for athletes in the PATS group was 22.2 +/- 8.3 days. This difference was not statistically significant (P = .2455). In the first 2 weeks after return to sports, reinjury rate was significantly greater (P = .00343, Fisher's exact test) in the STST group, where 6 of 11 athletes (54.5%) suffered a recurrent hamstring strain after completing the stretching and strengthening program, as compared to none of the 13 athletes (0%) in the PATS group. After 1 year of return to sports, reinjury rate was significantly greater (P = .0059, Fisher's exact test) in the STST group. Seven of 10 athletes (70%) who completed the hamstring stretching and strengthening program, as compared to only 1 of the 13 athletes (7.7%) who completed the progressive agility and trunk stabilization program, suffered a recurrent hamstring strain during that 1-year period. CONCLUSIONS: A rehabilitation program consisting of progressive agility and trunk stabilization exercises is more effective than a program emphasizing isolated hamstring stretching and strengthening in promoting return to sports and preventing injury recurrence in athletes suffering an acute hamstring strain. Future randomized clinical trials should investigate the potential for progressive agility and trunk stabilization programs in the prevention of hamstring strain injury during sports.

Acute Disease↗

PubMed1985

Activity of mono- and biarticular leg muscles during sprint running.

A cinematographic recording of the movements of the lower limbs together with simultaneous emg tracings from nine lower limb muscles were obtained from two male track sprinters during three phases of a 100 m sprint run. The extensor muscles of the hip joint were found to be the primary movers by acceleration of the body's center of gravity (C.G.) during the ground phase of the running cycle. The extensors of the knee joint were also important in this, but to a minor extent, while the plantar flexors of the ankle joint showed the least contribution. The biarticular muscles functioned in a way different from the monoarticular muscles in the sense that they perform eccentric work during the flight and recovery phases and concentric work during the whole ground phase (support), whereas the monoarticular muscles are restricted first to eccentric work and then to concentric work during the ground phase. Furthermore, the biarticular muscles show variation (and rate of variation) in muscle length to a larger extent than the monoarticular muscles. Paradoxical muscle actions appear to take place around the knee joint, where the hamstring muscles, m. gastrocnemius, m. vastus laterialis and m. vastus medialis act as synergists by extending the knee joint during the last part of the ground phase.

Ankle↗

PubMed2000

Transcutaneous FES of the paralyzed quadriceps: is knee torque affected by unintended activation of the hamstrings?

This study addresses the question whether unintended response of the knee flexors (hamstrings) accompanies transcutaneous functional electrical stimulation (FES) of the quadriceps and whether the knee torque is hereby affected. Transcutaneous FES of the right quadriceps of two paraplegic subjects was applied and measurements were made of the net torque and of the myoelectric activities of the quadriceps and hamstrings muscles of the right leg. A low correlation was obtained between the peak-to-peak amplitudes of the M-waves of the two muscles. This correlation decreased further with the development of fatigue, which indicated that the electromyography (EMG) signals from the hamstrings were not the result of cross-talk between adjacent recording sites. The force profile of each muscle was determined from a developed model incorporating EMG-based activation, muscle anthropometry as obtained from in vivo magnetic resonance imaging of the thigh, and metabolic fatigue function, based on data acquired by 31P nuclear magnetic resonance spectroscopy. A sensitivity analysis revealed that the muscle specific tension and the muscle moment arms have a major influence on the resulting muscle forces and should therefore be accurately provided. The results show that during the unfatigued phase of contraction the estimated maximal force in the hamstrings was lower than 20% of that in the quadriceps and could be considered to be practically negligible. As fatigue progressed the hamstrings-to-quadriceps force ratio increased, reaching up to 45%, and the effect of co-activation on the torque partition between the two muscles was no longer negligible.

Adult↗

PubMed1997

Interexaminer agreement for applied kinesiology manual muscle testing.

Two trials of the interexaminer reliability of Applied Kinesiology manual testing were conducted. On the first trial three clinicians, each with greater than ten years of experience with muscle testing procedures, tested 32 healthy individuals to estimate their agreement on the strength or weakness of right and left piriformis and right and left hamstring muscles. Significant agreement between examiners was found for piriformis muscles, but little significant agreement was noted when hamstrings were tested. In a second study, the same three examiners tested 53 subjects for strength or weakness of the pectoralis and tensor fascia lata muscles bilaterally. Significant interjudge agreement was found for pectoralis muscles, but no significant concordance could be found when the tensor fascia lata was examined.

Fascia Lata↗

PubMedDate not supplied

Hamstring injuries. Proposed aetiological factors, prevention, and treatment.

Injuries to the hamstring muscles can be devastating to the athlete because these injuries frequently heal slowly and have a tendency to recur. It is thought that many of the recurrent injuries to the hamstring musculotendinous unit are the result of inadequate rehabilitation following the initial injury. The severity of hamstring injuries is usually of first or second degree, but occasionally third-degree injuries (complete rupture of the musculotendinous unit) do occur. Most hamstring strain injuries occur while running or sprinting. Several aetiological factors have been proposed as being related to injury of the hamstring musculotendinous unit. They include: poor flexibility, inadequate muscle strength and/or endurance, dyssynergic muscle contraction during running, insufficient warm-up and stretching prior to exercise, awkward running style, and a return to activity before complete rehabilitation following injury. Treatment for hamstring injuries includes rest and immobilisation immediately following injury and then a gradually increasing programme of mobilisation, strengthening, and activity. Permission to return to athletic competition should be withheld until full rehabilitation has been achieved (complete return of muscle strength, endurance, and flexibility in addition to a return of co-ordination and athletic agility). Failure to achieve full rehabilitation will only predispose the athlete to recurrent injury. The best treatment for hamstring injuries is prevention, which should include training to maintain and/or improve strength, flexibility, endurance, co-ordination, and agility.

Athletic Injuries↗

PubMed2005

Electromyographic analysis of the knee during jump landing in male and female athletes.

Many noncontact anterior cruciate ligament (ACL) injuries in female athletes occur at foot strike during jump landing when the knee is extended. This study was undertaken to determine the activation level of the quadriceps and hamstring muscles electromyographically. Fifteen healthy volunteers (eight women and seven men), all of whom were collegiate basketball players, participated in the study. The maximum voluntary contraction (MVC) of the vastus medialis (VM) at a knee flexion angle of 15-45 degrees was significantly higher in women than in men. There was no significant difference in overall mean hamstring activity in men and women over the same knee flexion range. However, when the knee flexion angle was 15 degrees , 20 degrees , and 25 degrees , hamstring activity was significantly lower in female athletes. These results suggest that female athletes have a higher risk of ACL injury during jump landing due to increased anterior tibial translation force with quadriceps muscle activity. Female athletes require greater hamstring activation, and it is suggested that exercising this muscle will increase its activity when the knee is extended, thus preventing ACL injury during actual sport motions.

Adult↗

PubMed1980

Metabolic adaptation in phosphorylase kinase deficiency. Changes in metabolite concentrations during tetanic stimulation of mouse leg muscles.

1. Glycogen, nucleotides and glycolytic intermediates and products were measured before and during tetanus in the hamstrings-muscle groups of normal (C3H) and phosphorylase kinase-deficient (ICR/IAn) mice. 2. Phosphorylase kinase-deficient muscles contained 3-4-fold more glycogen and sustained a larger (approx. 2-fold), more rapid (11 +/- 2 ng/s faster) and more prolonged glycogenolysis during 120s tetanus despite their lack of phosphorylase a. 3. No significant change in total adenine nucleotide contents occurred during tetanus in either strain, but there was a 60-100-fold rise in IMP concentration to approx. 2mM in both strains. The initial rate of IMP formation was 6-fold more rapid (112 nmol/s per g) in phosphorylase kinase-deficient muscle. 4. Adenylosuccinate content rose to 36 nmol/g in phosphorylase kinase-deficient muscle and to 9 nmol/g in normal muscle at 45s tetanus, but then fell. 5. In phosphorylase kinase-deficient muscle, glucose 6-phosphate, a powerful phosphorylase inhibitor, was 56% of that in normal muscle. 6. The mass-action ratio of the phosphoglucomutase-catalysed reaction [glucose 6-phosphate]/[glucose 1-phosphate] was markedly lower than Keq. (approx. 17) in relaxed muscle of both strains (approx. 5-7), but rose significantly during tetanus to the value for Keq. 7. The data for IMP satisfy the criteria put forward by Rahim, Perrett & Griffiths [(1976) FEBS Lett. 69, 203-206] for a nucleotide activator of phosphorylase b: it should be present at a higher concentration in phosphorylase kinase-deficient muscle, its concentration should rise during muscle work, and it should attain a concentration comparable with its activation constant for phosphorylase b.

Animals↗

PubMed1989

The role of stretch and vestibulo-spinal reflexes in the generation of human equilibrating reactions.

Equilibrating reactions in standing humans were examined for evidence that either vestibulo-spinal or proprioceptive long loop stretch reflexes from ankle muscles, or both, are responsible for the control and organization of rapid postural responses. Specifically, the hypothesis was tested that the same postural response could be evoked by rotation of the support surface that mimics the ankle rotation occurring during support surface translations. Rotation perturbations evoked postural responses in leg and trunk muscles that were different in strategy, synergy and coactivation from translation responses, even though the short-latency response in the stretched triceps surae muscles was equal in latency and size. Movement patterns consisted of a stiffening strategy and hardly any compensating ankle rotation for rotation stimuli, and a multi-link strategy with motion focused about the neck, hip and ankle joints for translation stimuli. Dorsiflexion rotations caused earlier and stronger responses in tibialis anterior and quadriceps muscles just post to the onset of paraspinal muscles, whereas rearward translation activated soleus and abdominals strongest, both just prior to hamstring muscles. Correlated activation strengths of agonist and antagonist activity was a common feature for both types of perturbation, albeit, only in the ankle muscles for rotations and only in the trunk muscles for translations. These data suggest that sensory inputs, other than those generated in the lower leg predominate, in the triggering and modulation of equilibrating reactions. Possible candidates are those of the vestibular system or proprioceptive inputs from the trunk.

Humans↗

PubMed1991

In vivo analysis of intracellular thallium-201 accumulation in skeletal muscle of the rat.

The specific accumulation of the K(+)-analogue Tl+ (201Tl+) in muscle after intramuscular injection was analysed by gamma spectrometry in vivo of rat hamstring muscles. A mixture (0.1 ml) of 201Tl+ (thallous+ chloride-) and 99mTc-pertechnetate- (Na+ pertechnetate-) was given, by which 99mTc-pertechnetate- served as a reference substance with negligible intracellular accumulation. After 30 min 8.9 +/- 5.8% of injected 99mTc-pertechnetate- remained in the muscle and 49 +/- 10% of 201Tl+ (+/- SD, n = 18). The difference between 201Tl+ and 99mTc-pertechnetate- at 30 min was taken as a measure of the intracellular 201Tl+ accumulation, which was 40% of the initial amount of 201Tl+. The half-time of the calculated intracellular 201Tl+ accumulation was 4.9 +/- 1.9 min. In the presence of ouabain (1.0 mM in the injectate) the intracellular 201Tl+ accumulation was 25 +/- 10% (n = 7), that is ouabain decreased the intracellular 201Tl+ accumulation by 38% (P = 0.0035). Non-radioactive Tl+ (1.0 mM Tl-acetate in the injectate) inhibited the uptake by 35% (P = 0.0013). Ouabain did not significantly affect the half-time for the Tl+ uptake. An increase in [K+] of the injectate from 0 to 5 mM had no significant effect. Insulin (0.2 units in the injectate) had no effect. It is concluded that the specific Tl(+)-accumulating properties of muscle fibres can be studied with the present in vivo technique, which can provide information about the Na-K-ATPase activity and the membrane potential of muscle fibres.

Animals↗

PubMed2005

A comparison of bone-patellar tendon-bone and bone-hamstring tendon-bone autografts for anterior cruciate ligament reconstruction.

BACKGROUND: Most of the previous comparative studies between patellar tendon and hamstring tendon anterior cruciate ligament grafts compared grafts of different constructs fixed with different methods. PURPOSE: To compare patellar tendon and hamstring tendon grafts with the same fixation method used to reconstruct the anterior cruciate ligament. STUDY DESIGN: Randomized controlled trial; Level of evidence, 1. METHODS: During the reconstructive procedure, the hamstring tendon graft was prepared as a bone-hamstring-bone graft; both bone-patellar tendon-bone and bone-hamstring-bone grafts were fixed with interference screws. Eighty consecutive patients who underwent anterior cruciate ligament reconstruction were randomly assigned to either bone-patellar tendon-bone or bone-hamstring-bone groups. Follow-up examinations were performed for at least 5 years postoperatively. Seventy-two of the 80 patients (37 patients in the bone-patellar tendon-bone group and 35 in the bone-hamstring-bone group) were evaluated, with a mean follow-up period of 87.0 and 80.8 months, respectively. Follow-up examinations were performed using the International Knee Documentation Committee knee ligament standard and subjective knee forms. RESULTS: The mean KT-1000 arthrometer evaluation results showed no significant difference between the bone-patellar tendon-bone and bone-hamstring-bone groups (1.2 +/- 2.1 mm and 1.7 +/- 1.4 mm, respectively; P = .24). However, symptoms related to graft harvest (anterior kneeling pain) were more frequently observed in the bone-patellar tendon-bone group, and unsatisfactory results were correlated with severe kneeling pain in 3 patients from this group (P = .0056). Significant hamstring muscle weakness without complaint of functional deficit was found in the bone-hamstring-bone group (P = .0045). CONCLUSION: Bone-hamstring-bone grafts were shown to reduce the risk of problems at the graft harvest site compared to bone-patellar tendon-bone grafts, with comparable results in the remaining clinical parameters tested.

Adolescent↗