There is No Difference Between Quadriceps- and Hamstring Tendon Autografts in Primary Anterior Cruciate Ligament Reconstruction: a 2-year Patient-reported outcome Study

Overview

Journal Knee Surg Sports Traumatol Arthrosc

Publisher Wiley

Specialties Emergency Medicine
General Surgery
Orthopedics

Date 2017 May 7

PMID 28477270

Citations 44

Authors

Armin Runer

Guido Wierer

Elmar Herbst

Caroline Hepperger

Mirco Herbort

Peter Gfoller

Christian Hoser

Christian Fink

Affiliations

Soon will be listed here.

Abstract

Purpose: Graft choice for anterior cruciate ligament (ACL) reconstruction is crucial, however the optimal graft source remains a topic of controversy. The purpose of this study is to compare subjective and functional patient-reported outcomes (PRO) after single-bundle ACL reconstruction using quadriceps tendon (QT) or hamstring tendon (HT) autografts for single-bundle ACL reconstruction. We hypothesize that there is no difference in patient-reported functional outcomes after ACL reconstruction using either HT- or QT autograft.

Methods: All data were extracted from a prospectively collected ACL registry. A total of 80 patients with at least 2-year follow-up were included in this study. A total of 40 patients with primary ACL reconstruction using a QT autograft harvested via a minimally invasive technique were matched by sex, age and pre-injury Tegner and Lysholm score to 40 patients who received HT autografts. Subjective and functional PRO scores including Lysholm score, Tegner activity level and visual analogue scale for pain were obtained at 6, 12 and 24 months after index surgery.

Results: No significant difference between the QT and the HT group was seen at any follow-up in regard to any of the PRO scores for function or pain. 24 months post-surgery the mean Tegner activity score of the HT group was significantly (p = 0.04) lower compared to the pre-injury status. At final follow-up, 27 patients (67.5%) in the QT group and 32 patients (80.0%) in the HT returned to their pre-injury activity level (n.s.). A total of 37 patients (92.5%) of the QT cohort and 35 patients (87.5%) of the HT cohort reported "good" or "excellent" results according to the Lysholm score (n.s.). "No pain" or "slight pain" during severe exertion was reported by 33 patients (82.5%) with QT autograft and 28 patients (82.4%) with HT autograft (n.s.).

Conclusion: There is no significant difference between PRO 2 years post-operative using either QT or HT autografts. Both QT and HT grafts show acceptable and comparable PRO scores making the QT a reliable graft alternative to HT for primary ACL reconstruction.

Level Of Evidence: III.

Citing Articles

Efficacy and safety of quadriceps tendon autograft versus bone-patellar tendon-bone and hamstring tendon autografts for anterior cruciate ligament reconstruction: a systematic review and meta-analysis.

Zhang X, Liu P, Huang J, He Y J Orthop Traumatol. 2024; 25(1):65.

PMID: 39694948 PMC: 11656020. DOI: 10.1186/s10195-024-00801-2.

Comparison of Clinical Results Using Hamstring Versus Quadriceps Tendon Graft Versus Bone Patella Tendon in Anterior Cruciate Ligament Reconstruction Surgery: A Randomized Clinical Trial.

Fallah E, Naghshbandi M, Ghafoury R, Hosseini Zare N Med J Islam Repub Iran. 2024; 38:79.

PMID: 39678774 PMC: 11644201. DOI: 10.47176/mjiri.38.79.

Diagnosis and treatment of anterior cruciate ligament injuries: Consensus of Chinese experts part II: Graft selection and clinical outcome evaluation.

Chen T, Bai X, Bai L, Chan W, Chen S, Chen C J Orthop Translat. 2024; 48:163-175.

PMID: 39257437 PMC: 11385786. DOI: 10.1016/j.jot.2024.07.002.

Evolution of anterior cruciate ligament reconstruction & graft choice: a review.

Lind D, Patil R, Amunategui M, DePhillipo N Ann Jt. 2024; 8:19.

PMID: 38529255 PMC: 10929403. DOI: 10.21037/aoj-22-39.

Primary Versus Revision ACL Reconstruction Using Quadriceps Autograft: A Matched-Control Cohort Study.

Meena A, Farinelli L, Hoser C, Abermann E, Hepperger C, Patralekh M Orthop J Sports Med. 2024; 12(2):23259671231224501.

PMID: 38313755 PMC: 10836136. DOI: 10.1177/23259671231224501.

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