Hamstring and Quadriceps Autografts Revascularization after Anterior Cruciate Ligament Reconstruction: Evaluation with Magnetic Resonance Imaging

Ilias Ampatzis, John Gliatis, Fotios Efthymiou, Vasileios Metaxas, Christos Karavoulias, Eftychia Myritzi, Aikaterini Solomou


Purpose: Evaluation of the clinical outcome and the revascularization of five-strand single-bundle hamstring (SBH) and bone-quadriceps (BQ) tendon autografts used for ACL reconstruction.

Material and Methods: 46 patients included in the study, 26 underwent reconstruction with five-strand SBH (group A), while 20 with BQ tendon autograft (group B). All patients underwent MRI three days, six and twelve months postoperatively. The evaluations included the Lachman test, Tegner activity score, Biodex isokinetic test, Lysholm score and KT-1000 arthrometer displacement. The enhancement index (EI) was calculated in three specific sites of each graft and comparisons for every time interval were performed.

Results: Lachman test, Lysholm scores, Tegner activity scores and side-to-side difference values showed a significant improvement after surgery in both groups (P<.001). Regarding the knee extensor strength, no significant difference was found between the two groups, while flexor strength was significantly better in group B. QT showed better revascularization compared to HT grafts (P<.001) at six months, while no significant difference was observed twelve months after the surgery. The intra-articular site showed a higher EI (P<.001) compared to intraosseous tibial tunnel and intraosseous juxta screw sites at six months, while a non-significant increase was found twelve months after the surgery.

Conclusions: There was no difference between the two graft types regarding the stability and the functional outcome, except flexor muscle recovery where QT graft is better. Revascularization was better in QT graft in the sixth month, but there was no significant difference in the final follow-up after twelve months’ time interval.


Anterior cruciate ligament; magnetic resonance imaging; hamstring tendon; revascularization

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DOI: http://dx.doi.org/10.36162/hjr.v6i4.461


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