Return‐to‐sport outcomes after primary and revision anterior cruciate ligament reconstruction using quadriceps tendon autografts in highly active male athletes

Abstract Purpose To evaluate return‐to‐sport (RTS) outcomes following primary and revision anterior cruciate ligament reconstruction (ACLR) using quadriceps tendon autografts in a highly active male athletic population. Methods This retrospective cohort study included 140 highly active male athletes who underwent ACLR with a quadriceps tendon autograft by a single surgeon between 2014 and 2021. Participants were divided into primary ( n = 93) and revision ( n = 47) groups. All participants were surveyed regarding RTS outcomes at 2–3 years postoperatively. Survey outcomes included return to some kind of sport, return to preinjury sport (any level), return to preinjury sport at the same or higher level and self‐perceived ability to perform at the pre‐injury level. Descriptive statistics were calculated and presented. Results In the primary reconstruction cohort, 98.9% of athletes successfully returned to some sport, 90.3% to their pre‐injury sport, and 73.1% to their pre‐injury sport at the same or higher level. Of those who returned to their pre‐injury sport, 70.2% reported performing at their pre‐injury level. Of those who returned to their pre‐injury sport at the same or higher level, 79.4% reported performing at their pre‐injury level. In the revision cohort, 85.1% of athletes successfully returned to some sport, 57.4% to their pre‐injury sport and 40.4% to their pre‐injury sport at the same or higher level. Of athletes in the revision cohort who returned to their pre‐injury sport, 55.6% reported performing at their pre‐injury level. Of those who returned at the same or higher level, 57.9% reported performing at their pre‐injury level. Conclusion Quadriceps tendon autografts yielded high RTS rates in highly active male athletes after primary reconstruction and rates in the revision setting comparable to previous literature. A high proportion of the patients felt they could perform as well as prior to their injury. Level of Evidence Level III, retrospective cohort study.