Return to Sports Activity in Anterior Cruciate Ligament Reconstruction: 4-Strand Hamstring vs Quadriceps Tendon

Graft type selection is still a controversial issue in anterior cruciate ligament (ACL) reconstruction. The type of graft is a determinant of return to sport and its quality.

This study aims to evaluate results and rate of return to sport using quadriceps autograft compared to hamstring autograft.

The present prospective cohort study investigated the results of using quadriceps and hamstring autografts in athletes with an ACL tear. Our variables included age, sex, and body mass index, type of sports activity, infection, meniscus tear and chondral lesion, time and quality of return to sport, range of motion, KT-1000, Lachman and knee injury and osteoarthritis outcome score, international knee documentation committee grade, and Lysholm score.

A total of 71 out of 139 studied patients were operated on hamstring autografts and 68 patients by quadriceps autografts. The patients showed no significant differences (P>0.05) in terms of age, sex, body mass index, sports group, and meniscus tear. In the final follow-up, the chondral lesion was 26.47 vs 16.90, anterior knee pain was 5.8 vs 2.81, and the return to sport was 71.64 vs 78.87 in the quadriceps group vs the hamstring group. The extension loss involved 2 patients per group. The scores of the international knee documentation committee and knee injury and osteoarthritis outcome, the Lysholm test, KT-1000, and the Lachman test had no significant differences in the two groups.

The results of the present study indicated that the use of both quadriceps and hamstring autografts was appropriate for the ACL tear. Also, the orthopedic surgeon should be responsible for deciding to select one of the two grafts.