Summary
Comparing quadriceps tendon (QT) and hamstring tendon (HT) autografts for ACL reconstruction, our study found that although QT initially showed lower knee extension strength at 3 months postoperatively, it significantly improved and was comparable to HT at 6, 9, and 12 months, with no significant differences in knee flexion strength, IKDC score, and Tegner activity level recovery rates.
Abstract
Introduction
Quadriceps tendon (QT) autograft for anterior cruciate ligament (ACL) reconstruction is associated with concerns regarding postoperative decrease in knee extension strength. In this study, we compared the postoperative muscle strength recovery and clinical outcomes between the QT group and the hamstring tendon (HT) group in the initial ACL reconstruction performed at our institution.
Methods
The study included two groups: the HT group with 16 cases (9 males, 7 females; mean age 26.9 years) and the QT group with 11 cases (8 males, 3 females; mean age 24.2 years). Knee flexion/extension muscle strength was quantitatively assessed using Genu Line Isokinetic dynamometer (Easytech, Florence, Italy), and the changes were compared at preoperative, postoperative 3, 6, 9, and 12 months. Clinical evaluations were also conducted, comparing the preoperative and postoperative 12-month IKDC score and Tegner activity level.
Results
Knee extension strength in the QT group was significantly lower than in the HT group only at 3 months postoperatively (P < 0.01), but subsequently showed significant improvement, with no significant difference between the two groups at 6, 9, and 12 months postoperatively. There were no significant differences between the two groups in terms of knee flexion strength, IKDC score, and Tegner activity level recovery rates.
Discussion
ACL reconstruction using QT provides superior postoperative knee stability compared to HT and results in less postoperative anterior knee pain compared to bone-patellar tendon-bone (BTB). Previous studies have reported no differences in re-rupture rates and functional prognosis, and in this study, the extension strength in the QT group was equivalent to that in the HT group after 6 months postoperatively.
Conclusion
The use of QT autograft in ACL reconstruction was suggested as a viable alternative option.