Evidence map›Paper›PMID 40679231›Full record

SynthesisKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2026

Quadriceps, hamstring and patella tendon autografts for primary anterior cruciate ligament reconstruction demonstrate similar clinical outcomes, including graft failure, joint laxity and complications: A systematic review with meta-analysis of randomised controlled trials.

Ty White, Matthew Castro, Lucas Antonio, Wayne Hing, Francois Tudor, Larissa Sattler

Abstract readSystematic ReviewMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Ty WhiteInstitute of Health and Sport, Bond University, Gold Coast, Queensland, Australia.ORCID https://orcid.org/0009-0001-6712-6412
Matthew CastroInstitute of Health and Sport, Bond University, Gold Coast, Queensland, Australia.
Lucas AntonioInstitute of Health and Sport, Bond University, Gold Coast, Queensland, Australia.
Wayne HingInstitute of Health and Sport, Bond University, Gold Coast, Queensland, Australia.ORCID https://orcid.org/0000-0002-5507-9778
Francois TudorInstitute of Health and Sport, Bond University, Gold Coast, Queensland, Australia.ORCID https://orcid.org/0009-0006-9507-6113
Larissa SattlerInstitute of Health and Sport, Bond University, Gold Coast, Queensland, Australia.ORCID https://orcid.org/0000-0001-6023-8182

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeGraft failure following anterior cruciate ligament reconstruction (ACLR) remains a significant challenge, driving discussion for optimal graft choice. Traditionally, hamstring tendon (HT) and bone-patella tendon-bone (BPTB) autografts have been favoured for ACLR. Recently, quadriceps tendon (QT) usage has increased. This systematic review with meta-analysis aims to investigate the available evidence for QT compared to HT and BPTB autografts in terms of graft failure, clinical outcomes, functional outcomes and patient-reported outcome measures (PROMs).

methodsFive databases (PubMed, Cochrane, Embase, SPORTDiscus and CINAHL) were searched to identify randomised controlled trials comparing QT versus HT or BPTB autografts. Outcomes included graft failure, donor site morbidity, complications, reoperations, clinical measures, functional outcomes, and PROMs. Risk of bias was assessed using the Cochrane risk-of-bias tool (RoB2). Meta-analysis using a random effects model was conducted to determine the pooled risk ratio (RR) or mean difference (MD) with 95% confidence intervals (CIs), and certainty of evidence was evaluated via the GRADE approach.

resultsTwelve RCTs consisting of 636 patients were included. Meta-analysis revealed no differences in graft failure rates (RR = 1.00; 95% CI = 0.97-1.04; p = 0.83; I

conclusionQT autografts have similar outcomes for graft failure, laxity and PROMs compared to HT and BPTB; however, QT autografts may have lower donor site morbidity. While each graft type is associated with specific complications and post-operative strength deficits, all three remain viable options for ACLR. LEVEL OF EVIDENCE: Level I, systematic review of Level I randomised controlled studies.

Indexed as

Anterior Cruciate Ligament InjuriesAnterior Cruciate Ligament ReconstructionHamstring TendonsPatellar LigamentTendonsAutograftsGraft RejectionHumansJoint InstabilityPatient Reported Outcome MeasuresPostoperative ComplicationsRandomized Controlled Trials as TopicTransplantation, AutologousTreatment Outcomeanterior cruciate ligament reconstructionbone‐patellar tendon‐bonehamstring tendonquadriceps tendon

Identifiers

PMID40679231
PMCPMC13122740

What Socratic holds

Textmetadata
LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.