The Effect of Creatine Supplementation on Strength Recovery after Anterior Cruciate Ligament (ACL) Reconstruction: A Randomized, Placebo-Controlled, Double-Blind Trial

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.