Earlier strength recovery with partial‐thickness versus full‐thickness quadriceps tendon graft for anterior cruciate ligament reconstruction in competitive soccer players
Jose Luis Martin‐Alguacil, Manuel Arroyo‐Morales, Maria Lopez‐Garzon, Víctor Bolívar‐Arroyo, Irene Cantarero‐Villanueva, Juan M. Fernández‐Domínguez, Jose M. Rodriguez‐DelgadoAbstract
Purpose
This study aimed to compare strength recovery, functional and clinical outcomes between full‐ and partial‐thickness quadriceps tendon autografts for 12 months post‐operatively and to examine the clinical implications of graft thickness in anterior cruciate ligament reconstruction among non‐professional competitive soccer players.
Methods
42 non‐professional competitive Spanish federal soccer players who underwent primary anterior cruciate ligament reconstruction using either full‐ or partial‐thickness quadriceps tendon grafts were included in this retrospective cohort study. Both groups followed standardised surgical and rehabilitation protocols. Evaluations were assessed preoperatively and at 3, 6 and 12 months post‐operatively, with the reinjury rates recorded at 24 months. Quadriceps index, measured by isokinetic dynamometry was the primary outcome. Hamstring index, extension and flexion peak torque, single leg hop test, patient‐reported outcome measures (Lysholm and Cincinnati Knee Rating System scores) and reinjury rate were evaluated as secondary outcomes. Statistical analysis was performed using repeated‐measures ANCOVA with a Bonferroni adjustment, and the significance level was set at 5%.
Results
During the first 6 months, faster recovery of quadriceps symmetry was observed in partial‐thickness group compared to the full‐thickness group at 300°/s (mean difference: −26.5, 95% confidence interval [CI] [−51.4, −1.7], p = 0.037), 180°/s (mean difference: −31.0, 95% CI [−56.0, −6.0], p = 0.017), and 60°/s (mean difference: −31.2, 95% CI [−55.4, −7.0], p = 0.013), as well as greater improvement in extension peak torque. No statistical differences ( p > 0.05) remained between groups at 12 months, with both groups achieving similar recovery. Hop test and clinical outcomes improved significantly over time in both groups, without significant between‐group differences ( p > 0.05). Reinjury rate was similar between groups ( p = 0.634).
Conclusions
Earlier strength recovery was observed with partial‐thickness graft after ACL reconstruction, highlighting the clinical relevance of graft choice in early rehabilitation in competitive soccer players.
Level of Evidence
Level II.