Adolescent ACL Reconstruction Using Quadriceps or Hamstring Tendon Autografts: A Comparative Study of Muscle Strength and Patient-Reported Outcomes
Abstract
1. Introduction
2. Materials and Methods
2.1. Participants and Surgical Technique
2.2. Muscle Strength Evaluation (Isokinetic Measurement) by Biodex
2.3. Satisfaction Evaluation
2.4. Statistical Analysis
3. Results
3.1. Sample Characteristics
3.2. Muscle Strength Outcomes Between the Groups
3.3. Muscle Strength Outcomes Comparing Involved and Uninvolved Legs Between the Groups
3.4. Satisfaction Outcomes Between the Groups
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
Abbreviations
ACL | Anterior cruciate ligament |
ACLR | Anterior cruciate ligament reconstruction |
QT | Quadriceps tendon |
HT | Hamstring tendons |
IQR | Interquartile range |
H/Q | Hamstring-to-quadriceps ratio |
TQ/BW | Peak torque to body weight ratio |
IKDC | International Knee Documentation Committee score |
ACL-RSI | Anterior cruciate ligament return to sport after injury scale |
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QT (n = 24) | HT (n = 30) | Test Statistic | p Value | |
---|---|---|---|---|
Age in years (median (IQR)) | 15.5 (15–16.75) | 15 (14–16) | |Z| = 1.306 | 0.192 |
Sex (male/female) | 9/15 | 18/12 | χ2 = 1.875 | 0.171 |
Height in cm (median (IQR)) | 173.5 (169–181.5) | 177.5 (161–180) | |Z| = 0.157 | 0.875 |
Weight in kg (median (IQR)) | 65 (53.5–77.25) | 66.5 (62–78) | |Z| = 0.471 | 0.638 |
BMI Z-score (median; (IQR)) | 0.14 (−0.456–0.79) | 0.43 (0.21–0.83) | |Z| = 1.255 | 0.209 |
Meniscus (repaired/repair not required) | 12/12 | 15/15 | χ2 = 0 | 1 |
QT (n = 24) (Median; IQR) | HT (n = 30) (Median; IQR) | Test Statistic | p Value | |
---|---|---|---|---|
6 months post-surgery | ||||
Extensors peak TQ/BW in % | 121.45 (92.05–191.4) | 156.9 (109.3–260) | |Z| = 2.353 | 0.019 |
Flexors peak TQ/BW in % | 84.35 (49.65–110.56) | 75.2 (61.5–98) | |Z| = 0.471 | 0.638 |
H/Q Ratio | 56.1 (41.93–102.43) | 43.75 (39–55.7) | |Z| = 2.353 | 0.019 |
12 months post-surgery | ||||
Extensors peak TQ/BW in % | 208.55 (136.55–222.2) | 250.8 (168–332.1) | |Z| = 3.375 | <0.001 |
Flexors peak TQ/BW in % | 115.3 (91.98–122.95) | 91.25 (80.7–123.4) | |Z| = 1.569 | 0.117 |
H/Q Ratio | 57.2 (43.98–70.1) | 40.9 (37.2–49.7) | |Z| = 4.238 | <0.001 |
QT (n = 24) (Median; IQR) | Test Statistic | p Value | ||
---|---|---|---|---|
6 months post-surgery | ||||
Involved | Uninvolved | |||
Extensors peak TQ/BW in % | 121.45 (92.05–191.4) | 175.4 (162.2–256.65) | |Z| = 3.434 | <0.001 |
Flexors peak TQ/BW in % | 84.35 (49.65–110.56) | 84.35 (49.63–126.33) | |Z| = 0.773 | 0.455 |
H/Q Ratio | 56.1 (41.93–102.43) | 49.6 (39.7–56.9) | |Z| = 3.177 | <0.001 |
12 months post-surgery | ||||
Involved | Uninvolved | |||
Extensors peak TQ/BW in % | 208.55 (136.55–222.2) | 252.4 (204.18–290.28) | |Z| = 3.869 | <0.001 |
Flexors peak TQ/BW in % | 115.3 (91.98–122.95) | 116 (89.53–145.05) | |Z| = 2.146 | 0.031 |
H/Q Ratio | 57.2 (43.98–70.1) | 50.65 (45.2–55.78) | |Z| = 2.661 | 0.006 |
HT (n = 30) (Median; IQR) | ||||
6 months post-surgery | ||||
Involved | Uninvolved | |||
Extensors peak TQ/BW in % | 156.9 (109.3–260) | 232.1 (193.1–261.8) | |Z| = 4.478 | <0.001 |
Flexors peak TQ/BW in % | 75.2 (61.5–98) | 102.8 (89.2–126.2) | |Z| = 4.355 | <0.001 |
H/Q Ratio | 43.75 (39–55.7) | 47.2 (43.1−48.4) | |Z| = 1.390 | 0.165 |
12 months post-surgery | ||||
Involved | Uninvolved | |||
Extensors peak TQ/BW in % | 250.8 (168–332.1) | 293 (249.1–322) | |Z| = 3.490 | <0.001 |
Flexors peak TQ/BW in % | 91.25 (80.7–123.4) | 128.95 (97.8–153.6) | |Z| = 4.787 | <0.001 |
H/Q Ratio | 40.9 (37.2–49.7) | 48.4 (44.9–50.2) | |Z| = 3.366 | <0.001 |
QT (Median; IQR) | HT (Median; IQR) | Test Statistic | p Value | |
---|---|---|---|---|
IKDC | 87.94 (85.64–93.68) | 93.13 (88.51–98.85) | |Z| = 2.599 | 0.009 |
Lysholm | 95 (91–100) | 98 (95–100) | |Z| = 1.487 | 0.137 |
ACL-RSI | 70.67 (52.07–88.54) | 80.82 (70.83–92.5) | |Z| = 1.570 | 0.116 |
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Rakauskas, R.; Šiupšinskas, L.; Streckis, V.; Galinskas, L.; Jurkonis, R.; Tomkevičiūtė, J.; Malcius, D.; Čekanauskas, E. Adolescent ACL Reconstruction Using Quadriceps or Hamstring Tendon Autografts: A Comparative Study of Muscle Strength and Patient-Reported Outcomes. J. Clin. Med. 2025, 14, 3842. https://doi.org/10.3390/jcm14113842
Rakauskas R, Šiupšinskas L, Streckis V, Galinskas L, Jurkonis R, Tomkevičiūtė J, Malcius D, Čekanauskas E. Adolescent ACL Reconstruction Using Quadriceps or Hamstring Tendon Autografts: A Comparative Study of Muscle Strength and Patient-Reported Outcomes. Journal of Clinical Medicine. 2025; 14(11):3842. https://doi.org/10.3390/jcm14113842
Chicago/Turabian StyleRakauskas, Ritauras, Laimonas Šiupšinskas, Vytautas Streckis, Laurynas Galinskas, Rokas Jurkonis, Jūratė Tomkevičiūtė, Dalius Malcius, and Emilis Čekanauskas. 2025. "Adolescent ACL Reconstruction Using Quadriceps or Hamstring Tendon Autografts: A Comparative Study of Muscle Strength and Patient-Reported Outcomes" Journal of Clinical Medicine 14, no. 11: 3842. https://doi.org/10.3390/jcm14113842
APA StyleRakauskas, R., Šiupšinskas, L., Streckis, V., Galinskas, L., Jurkonis, R., Tomkevičiūtė, J., Malcius, D., & Čekanauskas, E. (2025). Adolescent ACL Reconstruction Using Quadriceps or Hamstring Tendon Autografts: A Comparative Study of Muscle Strength and Patient-Reported Outcomes. Journal of Clinical Medicine, 14(11), 3842. https://doi.org/10.3390/jcm14113842