2025 COA Annual Meeting: Soft-Tissue Quadriceps Autograft Acl-Reconstruction in the Skeletally-Immature Vs. Hamstrings (SQUASH): Feasibility of a Randomized Controlled Trial

One hundred skeletally-immature patients (ages 10–18) undergoing primary ACL reconstruction were randomized to receive either soft-tissue quadriceps autografts or hamstring tendon autografts. The primary outcome of interest was the reoperation rate within two years. Secondary outcomes included return-to-sport (Tegner Activity Scale), knee function (Paediatric-IKDC), range of motion, incidence of physeal injury and sequelae, persistent laxity, and adverse events. Outcomes will be assessed up to two years postoperatively. Overall, the results to date demonstrate that this trial is feasible, with high recruitment (100%), follow-up (90%), and data completion (94%) rates. These findings suggest that a global RCT comparing these grafts in pediatric ACL surgery is logistically feasible and methodologically sound.