{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T08:22:01Z","timestamp":1792052521790,"version":"4.4.0"},"reference-count":43,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,2,18]],"date-time":"2026-02-18T00:00:00Z","timestamp":1771372800000},"content-version":"vor","delay-in-days":48,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["esskajournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J. exp. orthop."],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Quadriceps tendon (QT), hamstring tendon (HT) and patellar tendon (PT) autografts are the most common grafts for anterior cruciate ligament reconstruction (ACLR). However, the specific impact of graft selection on postoperative knee extension and flexion strength remains controversial. This systematic review analysed randomised controlled trials (RCTs) comparing isokinetic muscle strength outcomes following primary ACLR using QT, HT or PT autografts.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A systematic review was conducted by searching Medline (PubMed), Epistemonikos and ScienceDirect (January 2014\u201310 May 2025) to identify RCTs that included patients aged \u226516\u202fyears undergoing primary, unilateral ACLR using an ipsilateral QT, HT or PT autograft. Studies had to report isokinetic strength outcomes at predefined postoperative intervals (approximately 3,\u202f6,\u202f12\u202fand\/or\u202f\u2265\u200924\u202fmonths) and at one or more angular velocities. The PRISMA guidelines were followed for literature analysis. Two reviewers independently screened, extracted and appraised data using the JBI Checklist for RCTs. A narrative synthesis was performed due to significant clinical and methodological heterogeneity among the included studies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of 1509 records screened, 13 RCTs met the criteria, encompassing 5 studies using QT, 13 HT and 4 PT. The synthesis revealed distinct recovery patterns: HT autografts showed more favourable recovery of knee extension strength, particularly between 6 and 12 months postoperatively. Conversely, QT autografts consistently resulted in superior recovery of knee flexor strength across all follow\u2010up periods. The results for PT autografts were heterogeneous, showing some short\u2010term advantages but no consistent superiority. Patient\u2010reported outcomes (PROMs) generally improved in all groups, though patterns varied by instrument and time point.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Current evidence indicates graft\u2010specific profiles of strength recovery after ACLR, with HT autografts favouring knee extension and QT autografts favouring knee flexion recovery. However, heterogeneity in testing protocols, angular velocities and the reporting of limb symmetry indices limits the strength of these conclusions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>Level I.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jeo2.70665","type":"journal-article","created":{"date-parts":[[2026,2,18]],"date-time":"2026-02-18T10:22:51Z","timestamp":1771410171000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Hamstring autografts favour knee extension strength recovery while quadriceps autografts optimise flexion strength recovery: A systematic review of randomised controlled trials"],"prefix":"10.1002","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-3629-0824","authenticated-orcid":false,"given":"Maximilian","family":"Heinz","sequence":"first","affiliation":[{"name":"Brandenburg Medical School, Center of Orthopedics and Traumatology University Hospital Brandenburg\/Havel Brandenburg an der Havel Germany"},{"name":"Faculty of Health Science Brandenburg Medical School Brandenburg an der Havel Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-9969-6189","authenticated-orcid":false,"given":"Jonathan","family":"Lettner","sequence":"additional","affiliation":[{"name":"Brandenburg Medical School, Center of Orthopedics and Traumatology University Hospital Brandenburg\/Havel Brandenburg an der Havel Germany"},{"name":"Faculty of Health Science Brandenburg Medical School Brandenburg an der Havel 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