Quadriceps Tendon vs Peroneus Longus Tendon in ACL Reconstruction

June 23, 2026 updated by: Muzaffer Agir, Acibadem University

A Prospective Randomized Clinical Trial Comparing Quadriceps Tendon and Peroneus Longus Tendon Autografts in Anterior Cruciate Ligament Reconstruction: Clinical, Functional, and Gait Analysis Outcomes

This prospective randomized clinical trial aims to compare quadriceps tendon and peroneus longus tendon autografts in anterior cruciate ligament reconstruction. Patients with anterior cruciate ligament injury undergoing primary reconstruction surgery will be randomly assigned to one of the two graft groups. Clinical examination findings, return-to-sport outcomes, ankle muscle strength, ankle-related functional scores, and gait analysis parameters will be evaluated at 6 months and 12 months postoperatively. The study aims to investigate both knee-related functional outcomes and donor site morbidity associated with graft harvesting techniques.

Study Overview

Status

Recruiting

Conditions

Intervention / Treatment

Detailed Description

Anterior cruciate ligament (ACL) reconstruction is one of the most commonly performed orthopedic procedures for restoring knee stability and enabling return to sports activities after ACL injury. Various autograft options have been described for ACL reconstruction, including hamstring tendon, bone-patellar tendon-bone, quadriceps tendon, and more recently, peroneus longus tendon grafts. Each graft option has unique biomechanical characteristics, advantages, and potential donor site morbidities.

Quadriceps tendon autografts have gained increasing popularity because of their adequate graft diameter, favorable biomechanical properties, and relatively low donor site complications. Peroneus longus tendon autografts have also emerged as a promising alternative graft source with satisfactory clinical outcomes and sufficient graft size. However, concerns remain regarding donor site morbidity, particularly potential effects on ankle muscle strength and ankle function following peroneus longus tendon harvesting.

This prospective randomized study aims to compare quadriceps tendon and peroneus longus tendon autografts in patients undergoing primary ACL reconstruction. Patients will be randomly assigned into two groups according to graft type. Clinical evaluations, functional knee scores, return-to-sport outcomes, ankle muscle strength assessments, ankle-related functional scores, and gait analysis parameters will be assessed during postoperative follow-up.

Follow-up evaluations will be performed at 6 months and 12 months after surgery. The findings of this study are expected to contribute to graft selection strategies in ACL reconstruction by providing comparative data regarding clinical outcomes, functional recovery, gait characteristics, and donor site morbidity.

Study Type

Interventional

Enrollment (Estimated)

60

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Turkey (Türkiye)
    • Besiktas
      • Istanbul, Besiktas, Turkey (Türkiye), 34349
        • Recruiting
        • Acibadem Fulya Hospital, Sport Medicine Center
        • Contact:

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • Patients diagnosed with anterior cruciate ligament rupture
  • Patients scheduled for primary anterior cruciate ligament reconstruction
  • Age between 18 and 50 years
  • Ability to provide informed consent
  • Willingness to comply with postoperative rehabilitation and follow-up evaluations

Exclusion Criteria:

  • Previous ligament reconstruction surgery on the affected knee
  • Multi-ligament knee injuries requiring additional ligament reconstruction
  • Severe osteoarthritis of the knee
  • Revision anterior cruciate ligament reconstruction
  • Neuromuscular disorders affecting lower extremity function
  • Active infection
  • Inability to comply with follow-up protocol

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Quadriceps Tendon Autograft
Patients undergoing anterior cruciate ligament reconstruction using quadriceps tendon autograft.
Procedure: Anterior Cruciate Ligament Reconstruction Using Quadriceps Tendon Autograft
Anterior cruciate ligament reconstruction performed using quadriceps tendon autograft.
Experimental: Peroneus Longus Tendon Autograft
Patients undergoing anterior cruciate ligament reconstruction using peroneus longus tendon autograft.
Procedure: Anterior Cruciate Ligament Reconstruction Using Peroneus Longus Tendon Autograft
Anterior cruciate ligament reconstruction performed using peroneus longus tendon autograft.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
International Knee Documentation Committee (IKDC) Subjective Knee Score
Time Frame: 12 months postoperatively
Comparison of postoperative subjective knee function between quadriceps tendon and peroneus longus tendon autograft groups using the International Knee Documentation Committee (IKDC) subjective knee evaluation form.
12 months postoperatively

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Return to Sport Rate
Time Frame: Assessment of return to pre-injury level of sports activity following anterior cruciate ligament reconstruction.
6 and 12 months postoperatively
Assessment of return to pre-injury level of sports activity following anterior cruciate ligament reconstruction.
Ankle Plantar Flexion Strength
Time Frame: 6 and 12 months postoperatively
Isokinetic ankle plantar flexion strength will be evaluated using an isokinetic dynamometer. Peak torque (Nm) during plantar flexion will be recorded and compared between study groups.
6 and 12 months postoperatively
Ankle Dorsiflexion Strength
Time Frame: 6 and 12 months postoperatively
Isokinetic ankle dorsiflexion strength will be evaluated using an isokinetic dynamometer. Peak torque (Nm) during dorsiflexion will be recorded and compared between study groups.
6 and 12 months postoperatively
Ankle Inversion Strength
Time Frame: 6 and 12 months postoperatively
Isokinetic ankle inversion strength will be evaluated using an isokinetic dynamometer. Peak torque (Nm) during inversion will be recorded and compared between study groups.
6 and 12 months postoperatively
Ankle Eversion Strength
Time Frame: 6 and 12 months postoperatively
Isokinetic ankle eversion strength will be evaluated using an isokinetic dynamometer. Peak torque (Nm) during eversion will be recorded and compared between study groups.
6 and 12 months postoperatively
Ankle Rotational Strength
Time Frame: 6 and 12 months postoperatively
Isokinetic ankle rotational strength will be evaluated using an isokinetic dynamometer. Peak torque (Nm) during rotational movements will be recorded and compared between study groups.
6 and 12 months postoperatively
Ground Reaction Force
Time Frame: 6 and 12 months postoperatively
Lower extremity biomechanical performance will be assessed using the VALD ForceDecks dual force plate system. Ground reaction force (N) during standardized standing and functional testing tasks will be recorded and compared between study groups.
6 and 12 months postoperatively
Force Asymmetry
Time Frame: 6 and 12 months postoperatively
Lower extremity biomechanical performance will be assessed using the VALD ForceDecks dual force plate system. Force asymmetry (%) during standardized standing and functional testing tasks will be recorded and compared between study groups.
6 and 12 months postoperatively
Weight Distribution
Time Frame: 6 and 12 months postoperatively
Lower extremity biomechanical performance will be assessed using the VALD ForceDecks dual force plate system. Weight distribution (%) during standardized standing and functional testing tasks will be recorded and compared between study groups.
6 and 12 months postoperatively

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Acibadem University

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

May 1, 2026

Primary Completion (Estimated)

May 1, 2027

Study Completion (Estimated)

December 1, 2027

Study Registration Dates

First Submitted

June 12, 2026

First Submitted That Met QC Criteria

June 23, 2026

First Posted (Actual)

June 26, 2026

Study Record Updates

Last Update Posted (Actual)

June 26, 2026

Last Update Submitted That Met QC Criteria

June 23, 2026

Last Verified

April 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • Quadriceps vs PL

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

UNDECIDED

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

Clinical Trials on Anterior Cruciate Ligament Rupture

Clinical Trials on Anterior Cruciate Ligament Reconstruction Using Quadriceps Tendon Autograft

Search Similar Trials

Sponsors and Collaborators

Medical Conditions

Drug Interventions

CROs by country

CROs in Albania

Conditions

Rare Diseases

Drug Interventions

Dietary Supplements

Sponsor/Collaborators

Locations

3
Subscribe