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Using a prospective, within\u2010subject case\u2013control design, we evaluated cellular\u2010level contractility, cross\u2010sectional area (CSA), and myosin heavy chain (MHC) isoform expression on single muscle fibers 3 weeks post ACLR, and evaluated their relationship to whole muscle strength and patient\u2010oriented outcomes 6 months post operation. Biopsies of the vastus lateralis were performed 3 weeks post ACLR in 11 subjects (5 females, mean age\u2009\u00b1<jats:italic>\u2009SD<\/jats:italic>\u2009=\u200924.7\u2009\u00b1\u20096.5\u2009years, height\u2009=\u2009172.7\u2009\u00b1\u20098.2\u2009cm, mass\u2009=\u200975.7\u2009\u00b1\u200912.5\u2009kg) following first\u2010time ACL rupture and whole muscle strength and self\u2010reported pain, function, and quality of life assessed 6 months post ACLR. At 3 weeks post ACLR, force production was reduced (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01) in MHC I (\u221236%) and IIA (\u221248%) fibers compared with the non\u2010injured leg. When force production was expressed relative to CSA to account for fiber atrophy, reductions remained in MHC IIA fibers (\u221240%; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), but MHC I fibers showed only a trend toward being lower (\u221213%; <jats:italic>p<\/jats:italic>\u2009=\u20090.09). Finally, skeletal muscle fiber functional deficits at 3 weeks post ACLR were associated with whole muscle weakness and less favorable patient\u2010reported outcomes at 6\u2010month follow\u2010up. Thus, ACLR promotes early cellular contractile dysfunction that may contribute to decreased whole muscle strength and patient function, and increased patient\u2010reported symptoms, at 6\u2010month follow\u2010up.<\/jats:p>","DOI":"10.1002\/jor.25065","type":"journal-article","created":{"date-parts":[[2021,5,10]],"date-time":"2021-05-10T07:39:48Z","timestamp":1620632388000},"page":"727-737","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Skeletal muscle cellular contractile dysfunction after anterior cruciate ligament reconstruction contributes to quadriceps weakness at 6\u2010month follow\u2010up"],"prefix":"10.1002","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6087-6894","authenticated-orcid":false,"given":"Timothy W.","family":"Tourville","sequence":"first","affiliation":[{"name":"Department of Rehabilitation and Movement Science University of Vermont  Burlington Vermont 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