Soft-tissue Quadriceps Autograft ACL Reconstruction in Skeletally Immature Patients Compared to Hamstring Autograft A Multi-Centre Randomized Controlled Trial

What this Trial Is About

Researchers are evaluating the use of quadriceps tendon autografts compared to the traditional hamstring autografts for primary Anterior Cruciate Ligament (ACL) reconstruction in children and adolescents aged 10 to 18 years with immature skeletons. This randomized controlled trial aims to compare these two graft options on outcomes such as ACL graft failure rates, return to sport, knee function, pain, quality of life, psychological readiness, range of motion, and adverse events over a 24-month period. This study addresses the lack of prior randomized trials in pediatric patients despite promising adult data and emerging evidence supporting quadriceps tendon use in youth. Participants will undergo arthroscopic-assisted, single-bundle, complete transphyseal ACL reconstruction with either a soft-tissue hamstring autograft or a soft-tissue quadriceps tendon autograft. The choice of graft fixation method is left to the surgeon's discretion based on current literature showing no clear superior fixation technique. Both study groups receive the same surgical technique differing only in the tendon used for reconstruction. During the 24 months following surgery, patients will be monitored for ACL failure incidence, return to sport, knee pain and function, health-related quality of life, psychological readiness, range of motion, and any adverse events. Assessments will include clinical evaluations and patient-reported outcomes to comprehensively evaluate the impact of the graft choice. The study involves multiple international centers and aims to enroll 352 skeletally immature participants with confirmed ACL insufficiency who were active in sports prior to injury.

Soft-tissue Quadriceps Autograft ACL-reconstruction in the Skeletally-immature vs. Hamstrings