Summary
This study aims to compare partial- and full-thickness quadriceps tendon autografts, focusing on muscle strength recovery and patient-reported outcomes.
Abstract
Introduction
Anterior cruciate ligament (ACL) reconstruction failure rates can reach up to 11.9%, underscoring the need for optimized surgical techniques. The quadriceps tendon autograft is gaining popularity due to its advantages, including greater graft thickness and reduced anterior knee pain. It can be harvested as either a partial-thickness or full-thickness graft, with no significant differences reported in systematic reviews. However, it remains unclear whether partial-thickness grafts facilitate faster muscle strength recovery, potentially enabling a safer and earlier return to sports. This study aims to compare partial- and full-thickness quadriceps tendon autografts, focusing on muscle strength recovery and patient-reported outcomes.
Methods
This ongoing study includes patients with primary ACL injuries undergoing reconstruction at the Orthopedics and Traumatology Sports Center (CETE), Paulista School of Medicine – Federal University of São Paulo, Brazil. Eligible participants are 18 years or older and have a confirmed diagnosis of a primary ACL injury. Patients with concomitant ligament injuries or a history of previous knee surgeries on the affected limb are being excluded. Participants are being assigned to two groups based on intraoperative tendon assessment and surgeon discretion:
Group 1: Full-thickness quadriceps tendon autograft
Group 2: Partial-thickness quadriceps tendon autograft
Muscle strength is being assessed using a handheld dynamometer at 3, 6, 9, and 12 months postoperatively, with isometric knee extension strength measured under standardized conditions. Clinical evaluations, including the IKDC subjective score and Tegner activity scale, are being conducted preoperatively and at 6 and 12 months postoperatively.
Expected Results
We hypothesize that patients receiving a partial-thickness quadriceps tendon graft will exhibit superior muscle strength recovery and better clinical outcomes compared to those with full-thickness grafts. Additionally, both quadriceps tendon graft groups (partial and full-thickness) are expected to demonstrate improved muscle strength recovery and clinical outcomes. These findings may help refine ACL reconstruction strategies and enhance postoperative rehabilitation protocols.