Quadriceps Strength and Hamstring-to-Quadriceps Ratios in Pediatric Patients After ACL Reconstruction: Revisiting Norms from Adult Data

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Cohort study found improved quadriceps strength but lower H:Q ratio in pediatric patients after ACL reconstruction, highlighting risks.

Pediatric patients demonstrated faster recovery for quadriceps strength and hop function compared to adults, which may influence reinjury rates.
The quadriceps strength limb symmetry index was significantly higher in pediatric patients at 9 months post-surgery, measuring 94% versus 88% in adults.
A matched cohort study compared pediatric and adult outcomes based on functional limb testing pre and post-ACL reconstruction, focusing on hamstring strength and H:Q ratios.
The lower hamstring-to-quadriceps ratio in pediatric patients suggests increased risk of reinjury, emphasizing the necessity for enhanced rehabilitation protocols.

Chopra et al. (2025) studied this question.

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