Influence of Graft Type on Muscle Contractile Dynamics After ACL Reconstruction: A 9-Month Tensiomyographic Follow-Up.

: Persistent neuromuscular deficits following anterior cruciate ligament reconstruction (ACLR) are frequently attributed to arthrogenic muscle inhibition (AMI). The type of autologous graft used may influence the trajectory of neuromuscular recovery. : To investigate the influence of graft type-bone-patellar tendon-bone (BPTB), hamstring tendon (HT), and quadriceps tendon (QT)-on the contractile properties of periarticular knee muscles over a 9-month post-operative period. : Each graft type would result in distinct recovery patterns of muscle contractility, as measured by tensiomyography (TMG). : Thirty-one patients undergoing ACLR with BPTB ( = 8), HT ( = 12), or QT ( = 11) autografts were evaluated at 3, 6, and 9 months post-operatively. TMG was used to measure contraction time (Tc) and maximal displacement (Dm) in the rectus femoris, vastus medialis, vastus lateralis, and biceps femoris. : Significant within-group improvements in Tc and Dm were observed across all graft types from 3 to 9 months (Tc: < 0.001 to = 0.02; Dm: < 0.001 to = 0.01). The QT group showed the most pronounced Tc reduction in RF (from 30.16 ± 2.4 ms to 15.44 ± 1.6 ms, < 0.001) and VM (from 31.05 ± 2.6 ms to 18.65 ± 1.8 ms, = 0.004). In contrast, HT grafts demonstrated limited Tc recovery in BF between 6 and 9 months compared to BPTB and QT ( < 0.001), indicating a stagnation phase. BPTB exhibited persistent bilateral deficits in both quadriceps and BF at 9 months. : Autograft type significantly influences neuromuscular recovery patterns after ACLR. TMG enables objective, muscle-specific monitoring of contractile dynamics and may support future individualized rehabilitation strategies.