ISAKOS Congress 2021

2021 ISAKOS Biennial Congress Paper

 

Quadriceps Tendon and Hamstring Tendon Autografts for Anterior Cruciate Ligament Reconstruction Yield Equally High Rates of Graft Failure, Revision ACLR or Re-Operation at Two Years Follow Up. A Registry Study With Review of Medical Records of475 Patients

Kristoffer W. Barfod, MD, PhD, VIRUM DENMARK
Malte Schmücker, Medical Student, Copenhagen DENMARK
Jørgen Haraszuk, MD, Copenhagen DENMARK
Per Hölmich, DMSc, Prof., Copenhagen DENMARK

Copenhagen University Hospital Hvidovre, Copenhagen, Copenhagen, DENMARK

FDA Status Not Applicable

Summary

QT and HT yield similar rates of graft failure, revision ACLR and re-operation at two years follow-up after ACLR. Graft failure was found in 9-11%. Revision ACLR was found in 2%.

Abstract

Background

It has been indicated that anterior cruciate ligament reconstruction (ACLR) with quadriceps tendon (QT) graft has a higher risk of revision compared to hamstring tendon (HT) graft.

Purpose

To investigate if ACLR with QT had higher risk of graft failure, revision ACLR or re-operation compared to HT in a high-volume center. We hypothesized that there would be no be-tween group difference.

Materials/methods: This was a registry study with review of medical records. Our study cohort consist of patients with primary ACLR using either QT or HT performed at Copenhagen University Hospital Hvidovre from January 2015 to December 2018. The cohort was identified from the Dan-ish Knee Ligament Reconstruction Registry and linked to the Danish National Patient Registry to identify all hospital contacts post-ACLR. The outcome variables were graft failure (re-rupture or >3mm side difference in A-P laxity), revision ACLR, re-operation due to cyclops, re-operation due to meniscal injury and re-operation due to any reason. Also, A-P laxity and pivot-shift were as-sessed at 1 year. Using Kaplan-Meier estimates, the rates of events were evaluated at 2 years and comparison performed with Cox regression analysis.

Results

475 subjects (HT=252, QT=223) were included. The risk of graft failure at 2 years was 9.4% for QT and 11.1% for HT (p= .46). Respectively, the risk of revision ACLR was 2.3% and 1.6% (p= .66), the risk of re-operation due to cyclops was 5.0% and 2.4% (p= .13), and the risk of re-operation due to meniscal injury was 4.3% and 7.1% (p= .16). The risk of re-operation due to any reason was 20.5% and 23.6% (p= .37). At 1-year follow-up A-P laxity was 1.4 mm for QT and 1.5 mm for HT (p= .35), and the proportion of patients with a positive pivot-shift was 29% for both groups.

Conclusion

QT and HT yield similar rates of graft failure, revision ACLR and re-operation at two years follow-up after ACLR. Graft failure was found in 9-11%. QT showed a non-statistically trend of higher risk for re-operation due to cyclops, and HT a non-statistically trend of higher risk for re-operation due to meniscal injury.

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