Quads vs hamstring tendon graft after an ACL surgery: is there a difference?

21st Feb, 2022

Key Points

  1. Quadriceps tendon graft is gaining popularity due to better strength and tendon thickness compared to hamstring tendon graft.
  2. There are no significant differences observed in the recovery of patients who received quadriceps tendon graft or hamstring tendon graft.

ACL graft for surgery

So you’ve been told that an ACL reconstruction (ACLR) is necessary, and your doctor has informed you of the graft options that are available for you. But now you can’t help but wonder what the difference is between the graft options presented, and if it would impact your recovery. Well, here’s the breakdown for you!

Types of ACL graft

  1. Bone-patella-tendon-bone graft (BPTB)
  2. Hamstring (semitendinosus, sartoirus and gracilis) graft (STG)
  3. Quadriceps tendon graft (QT)

An ACLR is commonly performed with a graft taken from the hamstring tendons or patellar tendon. However, the quadriceps tendon graft is becoming increasingly popular for its tendon thickness and strength compared to a hamstring (semitendinosus) tendon graft or patellar tendon graft.

Traditionally, STG was preferred to BPTB because STG was easier to harvest and presented lesser cases of knee pain and kneeling discomfort. Now with newer surgical techniques, there is a more efficient way to harvest a QT for ACLR that is comparable with the outcomes of  STG.

Quads tendon vs Hamstring tendon for ACL reconstruction surgery?

Based on a study comparing QT and STG, they looked at 3 factors to determine if one was better than the other. These factors were:

FactorsSTGQT
Strength Symmetry97%91%
Knee StabilityNo differenceNo difference
Donor Site Complications50%27%
3 factors being compared between STG & GT.

There are only slight differences seen in the recovery of patients who received QT and STG. QT does not have an inferior outcome as compared to STG. In addition, studies have found that a quadriceps tendon graft is stronger compared to the grafts harvested from the hamstring or the patellar. Therefore, rest assured that your recovery journey would not be any different whether you received QT or STG!

Book now to have a chat with our Physiotherapist who will be able to partner you in your recovery! 

DISCLAIMER: These advice should not replace the need for a consultation with a Physiotherapist or your Surgeon, especially if your condition doesn’t improve. Therapeutic exercise should be carefully selected to suit your condition.

Ref: 

Quadriceps tendon grafts does not cause patients to have inferior subjective outcome after anterior cruciate ligament (ACL) reconstruction than do hamstring grafts: a 2-year prospective randomised controlled trial. Lind M, Nielsen TG, Soerensen OG, et al. Br J Sports Med 2020;54:183–187.

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