Anterior Cruciate Ligament Injury, Anterior Cruciate Ligament Rupture
Conditions
Keywords
ACL reconstruction, Anterior cruciate ligament, Quadriceps tendon autograft, Peroneus longus tendon autograft, Gait analysis, Return to sport, Knee stability, Ankle muscle strength, Functional outcomes, Randomized controlled trial
Brief summary
This prospective randomized clinical trial aims to compare quadriceps tendon and peroneus longus tendon autografts in anterior cruciate ligament reconstruction. Patients with anterior cruciate ligament injury undergoing primary reconstruction surgery will be randomly assigned to one of the two graft groups. Clinical examination findings, return-to-sport outcomes, ankle muscle strength, ankle-related functional scores, and gait analysis parameters will be evaluated at 6 months and 12 months postoperatively. The study aims to investigate both knee-related functional outcomes and donor site morbidity associated with graft harvesting techniques.
Detailed description
Anterior cruciate ligament (ACL) reconstruction is one of the most commonly performed orthopedic procedures for restoring knee stability and enabling return to sports activities after ACL injury. Various autograft options have been described for ACL reconstruction, including hamstring tendon, bone-patellar tendon-bone, quadriceps tendon, and more recently, peroneus longus tendon grafts. Each graft option has unique biomechanical characteristics, advantages, and potential donor site morbidities. Quadriceps tendon autografts have gained increasing popularity because of their adequate graft diameter, favorable biomechanical properties, and relatively low donor site complications. Peroneus longus tendon autografts have also emerged as a promising alternative graft source with satisfactory clinical outcomes and sufficient graft size. However, concerns remain regarding donor site morbidity, particularly potential effects on ankle muscle strength and ankle function following peroneus longus tendon harvesting. This prospective randomized study aims to compare quadriceps tendon and peroneus longus tendon autografts in patients undergoing primary ACL reconstruction. Patients will be randomly assigned into two groups according to graft type. Clinical evaluations, functional knee scores, return-to-sport outcomes, ankle muscle strength assessments, ankle-related functional scores, and gait analysis parameters will be assessed during postoperative follow-up. Follow-up evaluations will be performed at 6 months and 12 months after surgery. The findings of this study are expected to contribute to graft selection strategies in ACL reconstruction by providing comparative data regarding clinical outcomes, functional recovery, gait characteristics, and donor site morbidity.
Interventions
PROCEDUREAnterior Cruciate Ligament Reconstruction Using Quadriceps Tendon Autograft
Anterior cruciate ligament reconstruction performed using quadriceps tendon autograft.
PROCEDUREAnterior Cruciate Ligament Reconstruction Using Peroneus Longus Tendon Autograft
Anterior cruciate ligament reconstruction performed using peroneus longus tendon autograft.
Sponsors
Acibadem University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Intervention model description
Participants will be randomly assigned to undergo anterior cruciate ligament reconstruction using either quadriceps tendon autograft or peroneus longus tendon autograft in parallel groups.
Eligibility
Sex/Gender
ALL
Age
18 Years to 50 Years
Healthy volunteers
No
Inclusion criteria
* Patients diagnosed with anterior cruciate ligament rupture * Patients scheduled for primary anterior cruciate ligament reconstruction * Age between 18 and 50 years * Ability to provide informed consent * Willingness to comply with postoperative rehabilitation and follow-up evaluations
Exclusion criteria
* Previous ligament reconstruction surgery on the affected knee * Multi-ligament knee injuries requiring additional ligament reconstruction * Severe osteoarthritis of the knee * Revision anterior cruciate ligament reconstruction * Neuromuscular disorders affecting lower extremity function * Active infection * Inability to comply with follow-up protocol
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| International Knee Documentation Committee (IKDC) Subjective Knee Score | 12 months postoperatively | Comparison of postoperative subjective knee function between quadriceps tendon and peroneus longus tendon autograft groups using the International Knee Documentation Committee (IKDC) subjective knee evaluation form. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Return to Sport Rate | Assessment of return to pre-injury level of sports activity following anterior cruciate ligament reconstruction. | 6 and 12 months postoperatively |
| Ankle Plantar Flexion Strength | 6 and 12 months postoperatively | Isokinetic ankle plantar flexion strength will be evaluated using an isokinetic dynamometer. Peak torque (Nm) during plantar flexion will be recorded and compared between study groups. |
| Ankle Dorsiflexion Strength | 6 and 12 months postoperatively | Isokinetic ankle dorsiflexion strength will be evaluated using an isokinetic dynamometer. Peak torque (Nm) during dorsiflexion will be recorded and compared between study groups. |
| Ankle Inversion Strength | 6 and 12 months postoperatively | Isokinetic ankle inversion strength will be evaluated using an isokinetic dynamometer. Peak torque (Nm) during inversion will be recorded and compared between study groups. |
| Ankle Eversion Strength | 6 and 12 months postoperatively | Isokinetic ankle eversion strength will be evaluated using an isokinetic dynamometer. Peak torque (Nm) during eversion will be recorded and compared between study groups. |
| Ankle Rotational Strength | 6 and 12 months postoperatively | Isokinetic ankle rotational strength will be evaluated using an isokinetic dynamometer. Peak torque (Nm) during rotational movements will be recorded and compared between study groups. |
| Ground Reaction Force | 6 and 12 months postoperatively | Lower extremity biomechanical performance will be assessed using the VALD ForceDecks dual force plate system. Ground reaction force (N) during standardized standing and functional testing tasks will be recorded and compared between study groups. |
| Force Asymmetry | 6 and 12 months postoperatively | Lower extremity biomechanical performance will be assessed using the VALD ForceDecks dual force plate system. Force asymmetry (%) during standardized standing and functional testing tasks will be recorded and compared between study groups. |
| Weight Distribution | 6 and 12 months postoperatively | Lower extremity biomechanical performance will be assessed using the VALD ForceDecks dual force plate system. Weight distribution (%) during standardized standing and functional testing tasks will be recorded and compared between study groups. |
Countries
Turkey (Türkiye)
Outcome results
None listed