Quadriceps tendon vs hamstring autograft in primary ACL reconstruction – a comparative study with minimum two-year follow-up


anterior cruciate ligament; quadriceps tendon; hamstring tendons; sports medicine; anterior cruciate ligament reconstruction

Published online: Aug 23 2022


Maria Victoria Pomenta Bastidas, Sergi Sastre, Josep Maria Segur Vilalta, Jose Rios, Marta Sabater, Dragos Popescu

From the Knee Unit, Hospital Clinic Barcelona, Barcelona, Spain


Recently there has been growing interest in the quadriceps tendon (QUAD) as a valid option for reconstruction of the anterior cruciate ligament (ACLR). The aims of the study is to compare the out- comes achieved in anatomic ACLR involving QUAD vs. Hamstring (HT) autografts.

A total of 52 consecutive patients underwent an ACLR, 25 patients with QUAD graft and 27 with HT graft. The same surgical technique, fixation method and postoperative protocol were used in both groups. The following parameters were evaluated: functional status (Lysholm, Tegner, subjective IKDC scores), joint stability (Lachman and pivot shift tests), surgical reoperation rate, complications, degree of satisfaction and return to previous level of activity. Descriptive statistics were analysed using the Student’s t-test.

Forty four patients were evaluated (20 QUAD, 24 HT), with a mean follow-up of 27.4 months. Two patients were re-operated in the QUAD group (including one ACL revision), and one patient in the HT group required an ACL revision. There were no significant differences between the two groups in postoperative scores: Lysholm (96.05 vs. 96.05), IKDC (86.2 vs. 91.2) and Tegner (6 vs. 5) scales. The percentage of negative Lachman and pivot shift tests was similar in the two groups (45% vs. 50% and 40% vs. 45.8%, respectively). There were no significant differences between the groups in the degree of satisfaction (95.8% vs. 80%, p = .16) or in the percentage who returned to their previous level of activity (62.5% vs. 45%, p = .17).

The use of a QUAD graft in ACL reconstruction leads to similar clinical and functional outcomes to those obtained with HT.