Return-to-sport outcomes after primary and revision anterior cruciate ligament reconstruction using quadriceps tendon autografts in highly active male athletes.

Olsen, Cecilie K; Feller, Julian A; Klemm, Haydn J; Webster, Kate E · J Exp Orthop · 2026

retrospective_cohort · Level III

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Abstract

To evaluate return-to-sport (RTS) outcomes following primary and revision anterior cruciate ligament reconstruction (ACLR) using quadriceps tendon autografts in a highly active male athletic population. This retrospective cohort study included 140 highly active male athletes who underwent ACLR with a quadriceps tendon autograft by a single surgeon between 2014 and 2021. Participants were divided into primary (<i>n</i> = 93) and revision (<i>n</i> = 47) groups. All participants were surveyed regarding RTS outcomes at 2-3 years postoperatively. Survey outcomes included return to some kind of sport, return to preinjury sport (any level), return to preinjury sport at the same or higher level and self-perceived ability to perform at the pre-injury level. Descriptive statistics were calculated and presented. In the primary reconstruction cohort, 98.9% of athletes successfully returned to some sport, 90.3% to their pre-injury sport, and 73.1% to their pre-injury sport at the same or higher level. Of those who returned to their pre-injury sport, 70.2% reported performing at their pre-injury level. Of those who returned to their pre-injury sport at the same or higher level, 79.4% reported performing at their pre-injury level. In the revision cohort, 85.1% of athletes successfully returned to some sport, 57.4% to their pre-injury sport and 40.4% to their pre-injury sport at the same or higher level. Of athletes in the revision cohort who returned to their pre-injury sport, 55.6% reported performing at their pre-injury level. Of those who returned at the same or higher level, 57.9% reported performing at their pre-injury level. Quadriceps tendon autografts yielded high RTS rates in highly active male athletes after primary reconstruction and rates in the revision setting comparable to previous literature. A high proportion of the patients felt they could perform as well as prior to their injury. Level III, retrospective cohort study.