{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T03:42:07Z","timestamp":1793763727592,"version":"4.6.1"},"reference-count":40,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T00:00:00Z","timestamp":1768176000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Am J Sports Med"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>The use of a quadriceps tendon (QT) autograft has gained popularity in recent years, and it has been called the \u201cgraft of the future.\u201d However, there is limited evidence of its sex-specific outcomes in female patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Purpose:<\/jats:title>\n                    <jats:p>To assess the outcomes of anterior cruciate ligament reconstruction (ACLR) with a QT autograft specifically in female patients and to elucidate any differences in sex-specific outcomes compared with male patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design:<\/jats:title>\n                    <jats:p>Systematic review; Level of evidence, 2.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>This systematic review was conducted in accordance with PRISMA guidelines using 4 online databases for a review of the literature. Studies using a QT autograft for ACLR but not reporting female-specific outcomes were excluded. Outcomes assessed included patient-reported outcomes, objective functional outcomes, and complications. A meta-analysis was performed in which data allowed for a comparison of outcomes with male patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      There were 9 studies included in this review, with a total of 714 female knees (mean age, 23.0 years) that underwent ACLR with a QT autograft. No difference was observed in the pooled graft failure rate between male and female patients at \u226524 months (8.8% vs 7.4%, respectively;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .50). Female patients had lower Tegner scores at 24 months (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .0007) and a lower quadriceps strength limb symmetry index at 6 months (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .0001). No significant difference was seen in the side-to-side difference in instrumented laxity measurements at 6 months (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .44) or in Lysholm scores at 24 months (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .52). The mean extension loss in female patients was 0.07\u00b0 (range, \u20130.22\u00b0 to 0.58\u00b0) at 24 months. The return-to-sport rate in female patients ranged from 71.4% to 82.7%.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Evidence from currently available literature suggests that there is no difference in graft failure rates between the sexes after ACLR with a QT autograft. Additionally, female patients have lower activity scores and slower quadriceps recovery compared with male patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/03635465251376649","type":"journal-article","created":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T08:00:57Z","timestamp":1768204857000},"page":"712-723","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":3,"title":["Anterior Cruciate Ligament Reconstruction With a Quadriceps Tendon Autograft in Female Patients Shows Equivalent Graft Failure But Lower Activity Scores and Slower Quadriceps Strength Recovery Compared With Male Patients: A Systematic Review and Meta-analysis"],"prefix":"10.1177","volume":"54","author":[{"given":"Anirudh","family":"Sharma","sequence":"first","affiliation":[{"name":"Birmingham Orthopaedic Training Programme, The Knowledge Hub, The Royal Orthopaedic Hospital NHS Foundation Trust, Birmingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muaaz","family":"Tahir","sequence":"additional","affiliation":[{"name":"Birmingham Orthopaedic Training Programme, The Knowledge Hub, The Royal Orthopaedic Hospital NHS Foundation Trust, Birmingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Osama","family":"Aweid","sequence":"additional","affiliation":[{"name":"Fortius Clinic, London, UK"},{"name":"Broomfield Hospital, Chelmsford, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tarek","family":"Boutefnouchet","sequence":"additional","affiliation":[{"name":"University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK"},{"name":"Birmingham Knee School, Birmingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tamer","family":"Sweed","sequence":"additional","affiliation":[{"name":"University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK"},{"name":"Birmingham Knee School, Birmingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amit","family":"Meena","sequence":"additional","affiliation":[{"name":"Shalby Hospital, Jaipur, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Darren L.","family":"de SA","sequence":"additional","affiliation":[{"name":"McMaster University, Hamilton, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel M.","family":"Frank","sequence":"additional","affiliation":[{"name":"University of Colorado School of Medicine, Aurora, Colorado, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"D\u2019Alessandro","sequence":"additional","affiliation":[{"name":"University of Western Australia, Crawley, Western Australia, Australia"},{"name":"Orthopaedic Research Foundation of Western Australia, Claremont, Western Australia, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5272-7410","authenticated-orcid":false,"given":"Shahbaz S.","family":"Malik","sequence":"additional","affiliation":[{"name":"Birmingham Knee School, Birmingham, UK"},{"name":"Worcestershire Acute Hospitals NHS Trust, Worcester, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,1,12]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-021-06443-9"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12178-022-09801-3"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546508330143"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2022-106099"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12178-021-09726-3"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1177\/03635465211030259"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1177\/03635465231222279"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1177\/19417381221079632"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2009.06.004"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-021-06845-9"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2022.11.027"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1186\/s41073-016-0007-6"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jisako.2023.11.002"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-020-06351-4"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2018.01.046"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.otsr.2024.103926"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-020-06220-0"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-019-05751-5"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1177\/23259671211054804"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.1302\/2633-1462.52.BJO-2023-0166"},{"key":"e_1_3_3_22_2","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.RVW.23.00057"},{"key":"e_1_3_3_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.asmr.2020.05.007"},{"key":"e_1_3_3_24_2","doi-asserted-by":"publisher","DOI":"10.1177\/23259671221076883"},{"key":"e_1_3_3_25_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546518825340"},{"key":"e_1_3_3_26_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546516652888"},{"key":"e_1_3_3_27_2","doi-asserted-by":"publisher","DOI":"10.1097\/JSM.0b013e318246ef9e"},{"key":"e_1_3_3_28_2","doi-asserted-by":"publisher","DOI":"10.1177\/03635465241262018"},{"key":"e_1_3_3_29_2","doi-asserted-by":"publisher","DOI":"10.1002\/ksa.12073"},{"key":"e_1_3_3_30_2","doi-asserted-by":"publisher","DOI":"10.3390\/app13116715"},{"key":"e_1_3_3_31_2","doi-asserted-by":"publisher","DOI":"10.1177\/23259671231197400"},{"key":"e_1_3_3_32_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2018.09.020"},{"key":"e_1_3_3_33_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546520931829"},{"key":"e_1_3_3_34_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546519854762"},{"key":"e_1_3_3_35_2","doi-asserted-by":"publisher","DOI":"10.26603\/001c.32378"},{"key":"e_1_3_3_36_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2023.07.019"},{"key":"e_1_3_3_37_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-017-4517-7"},{"key":"e_1_3_3_38_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546515573008"},{"key":"e_1_3_3_39_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546517749850"},{"key":"e_1_3_3_40_2","doi-asserted-by":"publisher","DOI":"10.1177\/03635465221146299"},{"key":"e_1_3_3_41_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2019.01.011"}],"container-title":["The American Journal of Sports Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/03635465251376649","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/03635465251376649","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/03635465251376649","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T09:25:16Z","timestamp":1779269116000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/03635465251376649"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,12]]},"references-count":40,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026,3]]}},"alternative-id":["10.1177\/03635465251376649"],"URL":"https:\/\/doi.org\/10.1177\/03635465251376649","relation":{},"ISSN":["0363-5465","1552-3365"],"issn-type":[{"value":"0363-5465","type":"print"},{"value":"1552-3365","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,12]]}}}