When Does Quadriceps ACL Graft Mature?

MRI data show quadriceps ACL graft signal normalizes by 12 months.

By
Kathryn Wighton
January 14, 2026
3 min

MDSpire News

Objective:

To evaluate the maturation of quadriceps tendon autografts following anterior cruciate ligament reconstruction using MRI signal intensity measurements.

Approach:

Key Findings:

Quadriceps tendon autografts showed significantly elevated MRI signal intensity at 3 and 6 months post-surgery.
By 12 months, the signal intensity of the grafts was not significantly different from the native ACL.
The most pronounced signal intensity differences were observed in the proximal portion of the graft.

Interpretation:

The study indicates that quadriceps tendon autografts undergo significant early changes in signal intensity, reflecting maturation, which aligns with the healing timeline of the native ACL.

Limitations:

Absence of histologic validation limited direct assessment of tissue-level remodeling.
Small, predominantly female cohort restricts generalizability to older populations and other graft types.
Signal intensity measures were dependent on imaging sequence and scanner.
Manual segmentation may have introduced variability in measurements.
Clinical outcomes were not assessed alongside imaging findings.

Conclusion:

Quadriceps tendon autografts demonstrate a maturation pattern that approaches native ACL characteristics by 12 months, with early signal intensity changes predominantly in the proximal graft region.