Adolescent ACL Reconstruction Using Quadriceps or Hamstring Tendon Autografts: A Comparative Study of Muscle Strength...

Area of Science:

• Orthopedic surgery
• Sports medicine
• Biomedical engineering

Background:

• Graft selection is crucial in adolescent anterior cruciate ligament reconstruction (ACLR).
• Quadriceps tendon (QT) autografts are an alternative to hamstring tendon (HT) autografts.
• Limited comparative data exists on adolescent muscle strength and satisfaction outcomes between QT and HT grafts.

Purpose of the Study:

• To compare muscle strength and patient satisfaction outcomes following ACLR using QT versus HT autografts in adolescents.
• To evaluate the functional recovery differences between graft types in a young patient population.

Main Methods:

• Prospective study of 68 adolescents (aged 12-17) undergoing ACLR with either QT or HT autografts.
• Muscle strength assessed via isokinetic dynamometry (Biodex).
• Patient satisfaction measured using IKDC, Lysholm, and ACL-RSI surveys preoperatively and at 12 months postoperatively.

Main Results:

• 54 patients completed the study.
• QT grafts showed significantly lower extension strength at 6 and 12 months post-op compared to HT grafts (p=0.019, p<0.001).
• QT grafts demonstrated better H/Q ratios at 6 and 12 months (p=0.019, p<0.001), with no significant differences in ACL-RSI or Lysholm scores, but lower IKDC scores (p=0.009).

Conclusions:

• Quadriceps tendon autografts offer improved H/Q ratios but are associated with reduced extension strength and lower patient satisfaction compared to hamstring tendon autografts in adolescent ACLR.
• Individualized rehabilitation protocols and further research are needed to optimize graft selection for adolescent ACLR.