ArticleOrthopaedic journal of sports medicine2026
Midterm Quadriceps Strength Outcomes of Revision ACL Reconstructions Comparing Ipsilateral Extensor Mechanism Autografts and Hamstring Tendon Autografts.
Article in Orthopaedic journal of sports medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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6 authors.
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Abstract
Background: Primary anterior cruciate ligament reconstructions (ACLRs) with extensor mechanism autografts (bone-patellar tendon-bone [BTB] or quadriceps tendon [QT]) have been reported to have lower quadriceps strength symmetry outcomes 6 months postoperatively as compared with those using a hamstring tendon (HT) autograft. However, the influence of a recurrent ipsilateral extensor mechanism graft harvest for a revision ACLR on quadriceps strength symmetry recovery is not well known. Purpose: To investigate the effect of ipsilateral revision ACLR autograft selection on the recovery of quadriceps limb symmetry index (Q-LSI) 6 months after a revision ACLR. Study Design: Cohort study; Level of evidence, 3. Methods: After revision ACLR, 53 patients were divided into 3 groups based on the ipsilateral autograft utilized for the primary and revision ACLR: hamstring to extensor (HT/Ext; ie, BTB or QT), extensor to hamstring (Ext/HT), and extensor to extensor (Ext/Ext). Six months after revision ACLR, patients completed an isometric quadriceps strength testing protocol on an isokinetic dynamometer; Q-LSI and quadriceps peak torque relative to body weight were then calculated and used for analysis. Separate analyses of covariance were conducted for each outcome using a multivariable linear regression framework, with group as the primary independent variable and age, sex, body mass index, and time since surgery included as covariates. Results: The Ext/HT group exhibited significantly greater quadriceps strength symmetry (Q-LSI = 88%) than the Ext/Ext group (Q-LSI = 69%; Conclusion: As compared with HT autografts, an ipsilateral BTB or QT autograft for a revision ACLR is associated with significantly lower Q-LSI values at the 6-month postoperative timepoint, regardless of the autograft type used for the primary ACLR.
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