Strength Recovery After Anterior Cruciate Ligament Reconstruction with Quadriceps Tendon Versus Hamstring Tendon Autografts in Soccer Players: A Randomized Controlled Trial

Background: The comparison between HT and QT grafts in strength recovery and function after an ACLR is scarce in the literature.

Methods: A total of 56 participants were enrolled in this randomized controlled trial and placed into two groups: HT or QT. The hamstring/quadriceps (H/Q) ratio was the primary end-point measured with a Genu-3 dynamometer. Peak torque, functional assessment (Lysholm knee scoring scale and Cincinnati Knee Rating System), and anteroposterior laxity (KT-2000™ arthrometer) were also assessed. An intention-to-treat analysis was performed.

Results: The results of the H/Q ratio analysis of the participants over time revealed significant differences at 60, 180, and 300°/s at three, six, and 12months of follow-up (60°/s: F=5.3, p=0.005; 180°/s: F=5.5, p=0.004; 300°/s: F=5.1, p=0.005). Furthermore, they revealed significant differences at 60°/s, 180°/s, and 300°/s in the participants over time for peak torque in the extensor muscle strength at three and six months of follow-up, with higher values in the hamstring tendon group but not at 12months of follow-up. There were no significant differences in functional endpoints or arthrometer assessments at 24months of follow-up.

Conclusion: An ACLR with a QT graft showed similar functional results with a better isokinetic H/Q ratio compared to an ACLR with the HT at 12months of follow-up in soccer players. This higher H/Q ratio observed with the QT could be an advantage of this graft over the HT for an ACLR.