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

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.