Anterior Cruciate Ligament Injuries, Knee Injuries
Conditions
Keywords
ACL reconstruction, hamstring tendon, quadriceps tendon, female athletes, autograft
Brief summary
This prospective multicenter cohort study aims to compare clinical and functional outcomes between hamstring tendon and quadriceps tendon autografts in anterior cruciate ligament (ACL) reconstruction in female athletes. Participants will be followed for two years after surgery to evaluate graft failure rates, return to sport, knee stability, and patient-reported outcomes.
Detailed description
Anterior cruciate ligament injuries are particularly prevalent in female athletes and represent a major challenge in sports medicine. The choice of graft type in ACL reconstruction may influence clinical outcomes, yet evidence specifically in female populations remains limited. This study prospectively enrolls female athletes undergoing ACL reconstruction with either hamstring tendon or quadriceps tendon autograft across multiple centers in Spain. Primary outcome is graft failure rate at 24 months. Secondary outcomes include return to sport rate, IKDC score, KOOS, Lysholm scale, limb symmetry index, and re-injury rate. Data will be collected preoperatively and at 6, 12, and 24 months postoperatively.
Interventions
PROCEDUREHamstring tendon autograft ACL reconstruction
ACL reconstruction using ipsilateral hamstring tendon autograft (semitendinosus and gracilis tendons) with arthroscopic technique
PROCEDUREQuadriceps tendon autograft ACL reconstruction
ACL reconstruction using ipsilateral quadriceps tendon autograft with arthroscopic technique
Sponsors
Universidad Católica San Antonio de Murcia
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
FEMALE
Age
16 Years to 35 Years
Healthy volunteers
No
Inclusion criteria
* Female patients aged 16 to 35 years with skeletal maturity * Active athlete: minimum two training sessions per week during the six months prior to injury in pivoting sports * Confirmed complete ACL rupture by MRI and clinical examination * Primary ACL reconstruction (first ligament surgery on the index knee) * Time from injury to surgery no longer than 6 months * Signed informed consent
Exclusion criteria
* Previous ligament surgery on either knee * Multiligament injury: simultaneous PCL, grade III MCL or LCL injury * Neuromuscular, rheumatological or systemic pathology interfering with rehabilitation or functional assessments * Pre-existing radiological osteoarthritis grade Kellgren-Lawrence ≥2 in the index knee * Inability to complete 24-month follow-up protocol * Pregnancy at inclusion or during follow-up period
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Graft failure rate | 24 months after surgery | Proportion of patients requiring revision ACL reconstruction or presenting with objetive graft rupture confirmed by MRI or arthroscopy |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| return to sport rate | 12 and 24 months after surgery | proportion of athletes who returned to their pre-injury sport level, assessed by athlete and surgeon |
| IKDC Subjective knee Evaluation Form | 6, 12 and 24 months after surgery | Patient-reported outcomes measure assessing knee symptoms, function and sports activity. |
| KOOS (Knee Injury and Osteoarthritis outcome Score) | 6, 12 and 24 months after surgery | Patient-reported outcome measure assessing pain, symptoms, function in daily living, function in sport and recreation, and knee-related quality of life |
| Lysholm Knee Scoring Scale | 6, 12 and 24 months after surgery | Clinician-reported outcome measure assessing knee function including pain, instability, locking, swelling, stair climbing, squatting and limp |
| Limb Symetry Index (LSI) | 6, 12 and 24 months after surgery | Assessed vy isokinetic dynamometry and single-leg hop tests to evaluate quadriceps and hamstring strength symmetry between limbs |
| Re-injury rate | 24 months after surgery | Proportion of patients sustaining a new ipsilateral or contralateral ACL injury during the follow-up period. |
Countries
Spain
Contacts
CONTACTLuis Gutiérrez Sánchez, MD
Outcome results
None listed