ArticleThe American journal of sports medicine2026
Patient-Reported Outcomes and Revision Rates After ACL Reconstruction With Quadriceps Versus Hamstring and Patellar Tendon Autografts: Sex-Stratified Results From the Swedish Knee Ligament Registry.
Article in The American journal of sports medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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6 authors.
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Abstract
backgroundQuadriceps tendon (QT) autografts are increasingly used worldwide in anterior cruciate ligament (ACL) reconstruction (ACLR). However, comparative outcome studies across graft types, particularly by sex, remain limited. PURPOSE: To compare patient-reported outcomes (PROs) and revision rates after primary ACLR with QT autografts in relation to patellar tendon (PT) and hamstring tendon (HT) autografts, stratified by sex. STUDY
designCohort study; Level of evidence, 3.
methodsPatients who underwent primary ACLR (2008-2022) were identified in the Swedish Knee Ligament Registry. The primary outcome was 2-year patient-reported knee function, assessed using the Knee injury and Osteoarthritis Outcome Score (KOOS). Clinical relevance was evaluated using the KOOS4 (mean of KOOS Pain, Symptoms, Sports/Recreation, and Quality of Life subscales), with thresholds for minimal important change (MIC, ≥9), patient acceptable symptom state (PASS, ≥79), and treatment failure (TF, ≤42). Adjusted logistic regression analyses assessed factors associated with MIC, PASS, and TF. The secondary outcome was 2-year revision ACLR, reported as rates and analyzed using Cox regression to estimate hazard ratios.
resultsA total of 18,920 patients (44%) had 2-year KOOS data available. Women receiving QT grafts had a lower proportion of MICs achieved than those with HT grafts (61% vs 71%;
conclusionQT autografts were associated with lower PROs compared with HT autografts in women, whereas no such differences were observed when compared with PT autografts or among men. Revision rates were similar across graft types, both overall and by sex.
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