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The Effect of Creatine Supplementation on Strength Recovery After Anterior Cruciate Ligament (ACL) Reconstruction

A Randomized, Placebo-Controlled, Double-Blind Trial

From NISMAT at Lenox Hill Hospital, New York, New York

^* Address correspondence to Timothy F. Tyler, NISMAT at Lenox Hill Hospital, 130 East 77th Street, New York, NY 10021.

Background: Creatine supplementation has been shown to augment training-induced strength gains. The purpose of this study was to examine the effect of creatine supplementation on recovery of muscle strength after anterior cruciate ligament (ACL) reconstruction.

Hypothesis: Creatine supplementation will facilitate strength gains after ACL reconstruction.

Study Design: Double-blind, prospective, and randomized clinical trial.

Methods: Sixty patients were randomized into creatine or placebo groups. Quadriceps and hamstring strength and power were measured isokinetically. Hip flexor, abductor, and adductor strengths were measured with a handheld dynamometer prior to surgery and at 6 weeks, 12 weeks, or 6 months after surgery.

Results: From 6 weeks to 12 weeks after surgery, there were significant increases in strength on the involved side for knee extension (47%), knee flexion (27%), hip flexion (20%), hip abduction (9%), and hip adduction (17%). These strength improvements were unaffected by creatine supplementation with similar effects in the creatine and placebo groups. From 6 weeks to 12 weeks after surgery, there were significant increases in power on the involved side for knee extension (46%) and knee flexion (26%), but these effects were not affected by creatine supplementation. At 6 months, creatine supplementation did not affect outcome as measured by the single leg hop test for distance or the knee outcome score.

Conclusions: The results demonstrate that patients do not benefit from creatine supplementation during the first 12 weeks of rehabilitation after ACL reconstruction.

Key Words: creatine • ACL • rehabilitation • atrophy • strengthening

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