Introduction It has been indicated that anterior cruciate ligament reconstruction (ACLR) with a quadriceps tendon (QT) graft has a higher risk of revision compared with ACLR performed with a hamstring tendon (HT) graft.

Materials and Methods This was a registry study with review of medical records of patients who underwent primary ACLR with either QT or HT graft performed at Copenhagen University Hospital Hvidovre. The cohort was identified from the Danish Knee Ligament Reconstruction Registry and linked to the Danish National Patient Registry to identify all hospital contacts after ACLR. The outcome variables were graft failure (rerupture or >3-mm side-to-side difference in anteroposterior [AP] laxity), revision ACLR, reoperation due to cyclops lesion, reoperation due to meniscal injury, and reoperation due to any reason. AP laxity and pivot shift were assessed at 1 year.

Results A total of 475 patients (252 HT, 223 QT) were included. The rate of graft failure at 2 years was 9.4% for the QT group and 11.1% for the HT group (P=.46). For the QT and HT groups, respectively, the rate of revision ACLR was 2.3% and 1.6% (P=.60), the rate of reoperation due to cyclops lesion was 5.0% and 2.4% (P=.13), and the rate of reoperation due to meniscal injury was 4.3% and 7.1% (P=.16). The rate of reoperation due to any reason was 20.5% and 23.6% (P=.37).

Conclusion QT and HT grafts yielded similar rates of graft failure, revision ACLR, and reoperation at 2 years of follow-up after ACLR.