SEQUAR SEmitendinosus vs QUadriceps in Anterior Cruciate Ligament Reconstruction

NCT ID: NCT04295148

Last Updated: 2025-09-18

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

Get a concise snapshot of the trial, including recruitment status, study phase, enrollment targets, and key timeline milestones.

Recruitment Status

RECRUITING

Clinical Phase

NA

Total Enrollment

200 participants

Study Classification

INTERVENTIONAL

Study Start Date

2020-02-10

Study Completion Date

2035-05-31

Brief Summary

Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.

Randomized control trial comparing two different Anterior Cruciate Ligament (ACL) grafts in Anterior Cruciate Ligament Reconstruction: the semitendinosus hamstrings graft and the quadriceps graft. Capio Artro Clinic (Stockholm) has vast experience in ACL surgery using both semitendinosus and quadriceps grafts.

Detailed Description

Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.

The purpose of the study is to evaluate the quadriceps graft with bone-plug in Anterior Cruciate Ligament Reconstruction (ACL-R) and compare it with the most common choice of graft, semitendinosus hamstrings graft in ACL-R in athletes with Tegner Activity Scale 7 or higher. Both methods are well-known and continually registered in the Swedish ACL Registry.

Both grafts will be compared post operatively as to knee laxity (primary outcome), PROMs, as well as measure graft site morbidity, Return to Sports rate, and the post-operative rehab. At 9 months we will also preform a MRI scan to determine graft maturity. 5-year and 10-year data will also be acquired through the Swedish ACL-registry and Lysholm score and Tegner Activity Level score. At 10-year a plain weight baring X-ray will be preformed to evaluate development of osteoarthritis.

The study design is a prospective randomized study with equal groups:

Semitendinosus graft (=100) and Quadriceps tendon graft (n=100). According to historical material from Capio Artro Clinic (Stockholm) the following power calculation has been made: Significance lever 5 percent (p=0.05) and power is 80%. The difference between the groups is 1 mm knee laxity with KT-1000 which would give an effect size of 0,44 or less compared to an average effect size (0,50). 85 individuals will be needed in each group in the statistical analysis. Although no stratification for sex will be performed, our aim is to have a balanced representation of sex that reflects the typical patient population for this condition at the clinic, with a distribution of 40% females and 60% males across both groups. Inclusion will continue until we have at least 100 individuals in each group. This means that each group can have more than 100 individuals. Randomization process and study design will be done according to the CONSORT guidelines.

Initially, the study was designed to have two primary outcome measures: KT-1000 knee laxity at 6 months and KOOS at 24 months. However, the study is only powered for the first outcome (Knee Laxity measured with KT-1000), therefore KOOS will be followed as a secondary outcome measure.

Conditions

See the medical conditions and disease areas that this research is targeting or investigating.

Anterior Cruciate Ligament Injuries Anterior Cruciate Ligament Rupture Anterior Cruciate Ligament Tear

Study Design

Understand how the trial is structured, including allocation methods, masking strategies, primary purpose, and other design elements.

Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

Review each arm or cohort in the study, along with the interventions and objectives associated with them.

Semitendinosus graft

Participants receive the Semitendinosus Graft technique during ACL reconstruction.

Group Type ACTIVE_COMPARATOR

ACL Reconstruction with Semitendinosus graft

Intervention Type PROCEDURE

Participants will undergo Anterior Cruciate Ligament Reconstruction with Semitendinosus graft

Quadriceps tendon-bone graft

Participants receive the Quadriceps Tendon-Bone Graft technique during ACL reconstruction.

Group Type ACTIVE_COMPARATOR

ACL Reconstruction with Quadriceps tendon-bone graft

Intervention Type PROCEDURE

Participants will undergo Anterior Cruciate Ligament Reconstruction with Quadriceps tendon-bone graft

Interventions

Learn about the drugs, procedures, or behavioral strategies being tested and how they are applied within this trial.

ACL Reconstruction with Semitendinosus graft

Participants will undergo Anterior Cruciate Ligament Reconstruction with Semitendinosus graft

Intervention Type PROCEDURE

ACL Reconstruction with Quadriceps tendon-bone graft

Participants will undergo Anterior Cruciate Ligament Reconstruction with Quadriceps tendon-bone graft

Intervention Type PROCEDURE

Other Intervention Names

Discover alternative or legacy names that may be used to describe the listed interventions across different sources.

ACL-R with Semitendinosus graft Semitendinosus ACL-R ACL-R with Quadriceps tendon-bone graft Quad tendon-bone ACL-R

Eligibility Criteria

Check the participation requirements, including inclusion and exclusion rules, age limits, and whether healthy volunteers are accepted.

Inclusion Criteria

* Pre-injury Tegner Activity Scale≥7
* Intended return to sports to prior sport and Tegner Activity Scale Level
* Time between injury and inclusion not more than 6 months
* MR verified ACL rupture

Exclusion Criteria

* Previous knee injury with symptoms before ACL injury
* Neurological disease, inflammatory disease, connective tissue disease or balance disorder
* Previous lower limb fracture or surgery
* Laxity in the medial collateral ligament (MCL) and lateral collateral ligament (LCL) \> grade 1
* PCL rupture or Multiligament knee injury (MLKI)
* Radiographic sign of osteoarthritis (OA)
* Previous knee surgery or ligament injury in contralateral knee
* Beighton score ≥ 5
Minimum Eligible Age

16 Years

Maximum Eligible Age

40 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

Meet the organizations funding or collaborating on the study and learn about their roles.

Karolinska Institutet

OTHER

Sponsor Role lead

Responsible Party

Identify the individual or organization who holds primary responsibility for the study information submitted to regulators.

Anders Stalman

Senior Consultant, Principal Investigator, Ph.D.

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

Learn about the lead researchers overseeing the trial and their institutional affiliations.

Anders Stålman, MD,PhD

Role: PRINCIPAL_INVESTIGATOR

Karolinska Institutet

Mikael Östin, MD

Role: PRINCIPAL_INVESTIGATOR

Capio Artro Clinic AB

Vasileios Sarakatsianos, MD

Role: PRINCIPAL_INVESTIGATOR

Karolinska Institutet

Joanna Kvist, PhD

Role: PRINCIPAL_INVESTIGATOR

Karolinska Institutet

Daniel Castellanos, MD

Role: PRINCIPAL_INVESTIGATOR

Karolinska Institutet

Locations

Explore where the study is taking place and check the recruitment status at each participating site.

Capio Artro Clinic AB

Stockholm, Stockholm County, Sweden

Site Status RECRUITING

Countries

Review the countries where the study has at least one active or historical site.

Sweden

Central Contacts

Reach out to these primary contacts for questions about participation or study logistics.

Anders Stålman, MD,Phd

Role: CONTACT

0046736665957

Facility Contacts

Find local site contact details for specific facilities participating in the trial.

Anders Stålman, MD, PhD

Role: primary

References

Explore related publications, articles, or registry entries linked to this study.

Castellanos Dolk D, Sarakatsianos V, Worner T, Ostin M, Cristiani R, Kvist J, Stalman A. Semitendinosus vs quadriceps tendon autograft in anterior cruciate ligament reconstruction (SEQUAR): protocol for a prospective randomized controlled trial. BMC Musculoskelet Disord. 2025 Oct 13;26(1):951. doi: 10.1186/s12891-025-09183-w.

Reference Type DERIVED
PMID: 41083992 (View on PubMed)

Other Identifiers

Review additional registry numbers or institutional identifiers associated with this trial.

DNR 2019-03359

Identifier Type: -

Identifier Source: org_study_id

More Related Trials

Additional clinical trials that may be relevant based on similarity analysis.