Functional and Clinical Outcomes Following Arthroscopic Anterior Cruciate Ligament Reconstruction Using Quadriceps Tendon Autograft

Open Access

Abstract

Background: Anterior cruciate ligament injury is a common cause of knee instability and functional limitation, particularly among young and active individuals. Quadriceps tendon autograft has emerged as a promising graft option with favorable biomechanical properties and potentially lower donor-site morbidity. Aim of the study: This study aimed to evaluate the functional and clinical outcomes of arthroscopic ACL reconstruction using quadriceps tendon autograft. Methods & Materials: A prospective observational study was conducted among 35 patients aged 18-50 years who underwent arthroscopic ACL reconstruction using an ipsilateral quadriceps tendon autograft at Department of Orthopaedic Surgery, National Institute of Traumatology and Orthopaedic Rehabilitation (NITOR), Dhaka, Bangladesh, from January 2024 to June 2026. Functional outcomes were assessed using Lysholm, IKDC, Tegner, and VAS scores, Knee stability was evaluated using the Lachman, anterior drawer, and pivot-shift tests. Patients were followed at 3, 6, and 12 months for functional recovery, range of motion, return to activity, satisfaction, complications, graft failure, and revision surgery. Data were analyzed using SPSS v26.0, with p<0.05 considered statistically significant. Results: Among 35 patients, the mean age was 28.6 ± 7.4 years, and 82.9% were male. At 12 months, the mean Lysholm score improved from 52.6 ± 8.9 to 91.2 ± 6.3, IKDC from 45.3 ± 7.6 to 88.2 ± 6.5, and Tegner score from 2.9 ± 1.0 to 5.8 ± 1.2, while VAS pain decreased from 5.2 ± 1.3 to 0.6 ± 0.7; all changes were significant (p<0.001). At final follow-up, 82.9% had Grade 0 Lachman, 85.7% had a Grade 0 anterior drawer test, 94.3% had a negative pivot-shift test, and 97.1% regained full range of motion. Return to previous activity or sport was achieved by 82.9%, while graft failure occurred in 2.9%. Conclusion: Arthroscopic ACL reconstruction using quadriceps tendon autograft resulted in favorable functional recovery, improved knee stability and range of motion, reduced pain, and a return to activity, with low graft failure and complication rates. Quadriceps tendon autograft appears to be an effective and reliable option for primary ACL reconstruction.