Functional Outcome of Single Bundle ACL Reconstruction with Superficial Quadriceps Tendon Graft in an Indian Cohort:...

There are only a few studies on the functional outcome of anterior cruciate ligament reconstruction using quadriceps tendon (QT) autograft. The available evidence highlights many advantages of this technique. The graft is thicker and stronger with less donor site morbidity and there is much less kneeling pain as compared to patellar tendon grafts. It is very versatile and allows harvesting as an all-soft tissue or bone-tendon graft, thereby making it suitable for various groups of patients and various surgical techniques.

To evaluate the functional outcome associated with anterior cruciate ligament reconstruction using quadriceps tendon autograft.

A prospective study was conducted over a period of 3 years in a Tertiary Care Orthopedics department. The study included male and female patients aged between 20 and 50 years with symptomatic isolated ACL tears and a BMI below 40 kg/m². Patients were excluded if they had associated meniscal, cartilage, or posterior cruciate ligament injuries, bilateral or multiple knee ligament injuries, ipsilateral ankle injuries, prior knee or ankle surgery, osteoarthritic changes, active infection or restricted knee motion, or fractures involving the knee. These patients underwent ACLR with QT autograft. Functional outcomes were assessed with standardized scoring systems (Lysholm Knee Score, Subjective IKDC, Tegner Activity Scale) pre-operatively, at 1 and 3 years post-operatively.

The study included 50 patients with ACL injuries, most of whom were aged between 20 and 30 years and predominantly male. Nearly half of them had a healthy BMI, with the remainder being overweight or obese. Injuries were commonly caused by road traffic accidents and sports activities, and the right knee was more frequently affected. Following ACL reconstruction with a quadriceps tendon autograft, significant improvement in clinical outcomes was observed. Most of the patients experienced no post-operative complications, while a small number developed superficial infection, anterior knee pain, or knee stiffness.

Even though the use of QT for ACL reconstruction has become popular in recent times, only a few surgeons are using it as the preferred primary graft option. Several clinical studies have shown that ACL reconstruction using the quadriceps tendon autograft offers comparable, and, in some cases, superior functional outcomes to hamstring and patellar tendon grafts. In our study, ACLR using QT autograft provided satisfactory clinical results and functional outcomes with relatively low rates of complications. Given its consistent results and adaptability for both primary and revision procedures, the quadriceps tendon autograft should be considered as a preferred graft choice for ACL reconstruction surgeries.