ArticleKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2023
Quadriceps autograft is a viable graft choice for arthroscopic ACL reconstruction in patients over 50 years of age.
Article in Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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11 citing papers in PubMed, 21 citations in OpenAlex.
- Clinical outcomes and failure rates of combined 'Over-the-Top' anterior cruciate ligament reconstruction and lateral extra-articular tenodesis in a cohort of patients with an average age of 60 years.Journal of experimental orthopaedics · 2026Article
- Clinical outcomes of quadriceps, hamstring, and bone-patellar tendon-bone autografts for ACL reconstruction: a meta-analysis of randomized controlled trials.Knee surgery & related research · 2026Review
- Advances in anterior cruciate ligament reconstruction: Risk stratification, graft choices, and functional recovery in 2026.Journal of experimental orthopaedics · 2026Review
- A simplified algorithm to work up graft re-rupture following anterior cruciate ligament reconstruction.Bulletin of the Hospital for Joint Disease (2013) · 2025Review
- Significant Variation in Quadriceps Tendon Thickness Is Observed Among Cadaveric Specimens.Arthroscopy, sports medicine, and rehabilitation · 2025Article
- Biological Versus Synthetic Grafts in ACL Reconstruction: A Comparative Analysis of Failure Rates, Knee Stability, and Functional Outcomes.Acta medica Lituanica · 2025Article
- Clinical Results of Isolated MCL Grade III Injury in Acute and Chronic Setting: Systematic Review and Meta-analysis.Indian journal of orthopaedics · 2024Article
- Effect of Quadriceps Tendon Autograft Preparation and Fixation on Graft Laxity During Suspensory Anterior Cruciate Ligament Reconstruction: A Biomechanical Analysis.Orthopaedic journal of sports medicine · 2024Article
- Primary Versus Revision ACL Reconstruction Using Quadriceps Autograft: A Matched-Control Cohort Study.Orthopaedic journal of sports medicine · 2024Article
- Anterior Cruciate Ligament Reconstruction Improves Functional Scores and Quality of Life in Patients Older Than 50 Years of Age.Arthroscopy, sports medicine, and rehabilitation · 2023Article
- ACL Graft Selection Based on Age and Sport.Video journal of sports medicineArticle
Corrections and comments
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Authors and funding
8 authors at 5 institutions in 5 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeThe purpose of this study was to evaluate the patient-reported outcomes, graft failure, quadriceps rupture and sports preference after arthroscopic ACL reconstruction in patients older than 50 years who underwent arthroscopic ACL reconstruction with a quadriceps tendon (QT) autograft.
methodsBetween 2010 and 2020, prospectively collected data were obtained from an institutional database. Patients older than 50 years with primary arthroscopic ACL reconstruction and a minimum of 2 years of follow-up were included. Patients undergoing a revision ACL reconstruction or undergoing a primary ACL reconstruction using a graft other than a QT autograft, and patients with a contralateral knee injury or osteoarthritis (Ahlbäck stage 2 or higher) were excluded. A minimally invasive technique was used for QT autograft harvesting. Patients were evaluated for pre-injury and 2-year follow-up Lysholm knee score, Tegner activity level, Visual Analog Scale (VAS) for pain, graft failure, quadriceps tendon rupture, and return to sport.
resultsA total of 57 patients were included in the study. The mean age of the cohort was 54.9 ± 5.2 (range 50-75). Of the 57 reconstructions, 16 (28%) were isolated ACL reconstructions, while 41 (72%) were complex reconstructions (concomitant meniscus, cartilage and/or collateral ligament injuries). At the 2-year follow-up Lysholm knee score, Tegner activity level and VAS for pain improved to pre-injury level and no significant difference was noted between pre-injury and 2-year follow-up functional scores (n.s.). No case of graft failure or quadriceps tendon rupture was reported. No significant difference was noted in the pre-injury and postoperative sports preference (n.s.) and all patients return to their desired sports activity.
conclusionArthroscopic ACL reconstruction by using QT autograft in highly active older patients provides satisfactory patient-reported functional outcomes and allows recovery of the pre-injury level of activity. QT autograft is a good graft option in patients older than 50 years. LEVEL OF EVIDENCE: Level IV.
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