Twin Soccer Athletes with Simultaneous ACL Tears - Which Graft Would You Choose?

Overview

This report discusses the successful ACL reconstruction surgeries performed on identical twin soccer athletes using quadriceps tendon autografts. Both athletes returned to play within the same high school soccer season after their injuries.

Background

ACL injuries are common among young athletes, particularly in sports requiring pivoting movements, such as soccer. The choice of graft type for ACL reconstruction is critical, as it can influence recovery outcomes and the risk of reinjury. The quadriceps tendon autograft is emerging as a favorable option due to its robust tissue volume and favorable functional outcomes.

Data Highlights

No numerical data provided in the article.

Key Findings

• Both twins suffered ACL injuries within five weeks of each other during their junior soccer season.
• Quadriceps tendon autografts were chosen for their superior tissue volume and strength compared to other graft types.
• The remaining quadriceps tendon post-harvest is still 80% stronger than the intact patellar tendon.
• Successful surgeries allowed both athletes to return to play by their senior year.
• Utilization of the Motion Analysis Lab aids in customizing rehabilitation and assessing readiness for return to sports.

Clinical Implications

Surgeons should consider quadriceps tendon autografts for young female athletes undergoing ACL reconstruction due to their favorable outcomes and lower donor site morbidity. Continuous assessment of physical readiness through motion analysis can enhance recovery and reduce reinjury risks.

Conclusion

The case of the twin athletes illustrates the effectiveness of quadriceps tendon autografts in ACL reconstruction, emphasizing the importance of tailored rehabilitation strategies for optimal recovery.

References

1. Knee Surgery, Sports Traumatology, Arthroscopy, 2016 -- Comparative Biomechanics of Graft Configurations in Anterior Cruciate Ligament Reconstruction
2. Knee Surgery, Sports Traumatology, Arthroscopy, 2012 -- Comparative Biomechanical Analysis of Various Graft Positions in Single-Bundle Anterior Cruciate Ligament Reconstruction
3. Archives of Orthopaedic and Trauma Surgery, 2026 -- Comparison of patellar tendon and hamstring grafts in ACL reconstruction: patellar tendon shows lower re-rupture rates in high-risk groups and comparable patient-reported outcomes in lower-risk patients
4. Sport-Specific Considerations in ACL Reconstruction: Diagnostic Evaluation and Graft Selection - PMC
5. Quadriceps versus hamstrings autograft in anterior cruciate ligament reconstruction: a randomized control trial - PubMed
6. Innovative Hamstring Autograft Method Using a Single Antegrade Sling Graft for Simultaneous Reconstruction of the Anterior Cruciate Ligament and Anterolateral Ligament
7. Sport-Specific Considerations in ACL Reconstruction: Diagnostic Evaluation and Graft Selection - PMC
8. Quadriceps versus hamstrings autograft in anterior cruciate ligament reconstruction: a randomized control trial - PubMed
9. Return to sport after ACL reconstruction in female athletes: a meta-analysis of return rates and time to return | Journal of Orthopaedic Surgery and Research | Springer Nature Link