Comparable isokinetic quadriceps performance six months after ACL reconstruction with rectus femoris versus hamstring tendon autografts

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Abstract
Purpose: To compare isokinetic quadriceps performance 6 months after anterior cruciate ligament reconstruction (ACLR) using rectus femoris (RF) versus hamstring tendon (HT) autografts. Methods: In this cross‐sectional study, 75 male patients who underwent primary ACLR with RF ( n = 31) or HT ( n = 44) autografts were evaluated ~6 months postoperatively. Bilateral isokinetic testing at single angular velocity 60°/s (Biodex Multi‐Joint System 4) measured peak torque (PT), PT normalized to body weight (PT/BW), angle at peak torque (aPT), total work (TW), and mean power (PM). Between‐group comparisons used independent t‐tests; paired comparisons were conducted within the RF group. Results: No between‐group differences were detected for PT, PT/BW, aPT, TW, or PM ( p > 0.05 for all—primary contrast PT: mean diff. 5.3 Nm; 95% CI –20.4 to 30.9; p = 0.689). Within the RF group, the operated limb showed lower PT, PT/BW, TW, and PM than the contralateral limb (all p ≤ 0.002), with no difference in aPT. Conclusions: At 6 months after ACLR, quadriceps performance did not differ between RF and HT autografts. These early data do not address return‐to‐sport timing or graft healing and should not be interpreted as evidence of equivalence (it is not powered for equivalence/non‐inferiority); rather, they support RF as a potential option warranting longer‐term studies incorporating functional tests and patient‐reported outcomes. Level of Evidence: Level III, cross‐sectional comparative study.

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