Summary

QT autograft may be a suitable alternative to BPTB autograft in young athletes undergoing ACLR

Abstract

Purpose

All soft tissue quadriceps tendon (QT) autograft for anterior cruciate ligament reconstruction (ACLR) allows for easy harvest of robust tissue, but it is unclear if patient outcomes are similar to those of bone-patella tendon-bone (BPTB) autograft, which is currently considered to be the gold standard graft source for young athletes. Our goal was to compare patient reported outcomes (PROs) in young athletes undergoing ACLR with either QT or BPTB autograft. We hypothesized that there would be no difference between groups.

Methods

Data from adolescent and young adult (12-25 years old) patients who were participating in competitive athletics at the time of ACL injury and underwent ACLR using a BTB or QT autograft at a single institution were included in this retrospective database study. Patient demographics and surgical characteristics were confirmed via chart review. Patients completed the International Knee Documentation Committee Subjective Knee Form (IKDC) and the Max Activity Scale via an online survey. Demographic characteristics and PROs were compared between patients with BTB and QT autografts using independent samples t-test except for distribution of patient sex which was compared between groups using a ?2 test. A-priori alpha level was p<0.05.

Results

Data from forty-seven patients (12 QT and 35 BPTB) who completed the online survey were included at a mean follow-up of 2.6 years. The BTB group were significantly older than patients in the QT group (p=0.01; Table). There were no significant between group differences in patient sex (p=0.44), Marx activity score p=0.50) nor IKDC score (p=0.69; Table). There was one graft failure in the BTB group and no graft failures in the QT group; however, statistical comparison was not completed due to low failure frequency.

Conclusions

At 2.63 year follow-up, patients with QT and BPTB autograft reported similar levels of activity and knee-related function. These results suggest that QT autograft may be a suitable alternative to BPTB autograft in young athletes undergoing ACLR.

Key Terms: anterior cruciate ligament; quadriceps tendon; bone-patellar tendon-bone, young athlete

Table. Between group comparison of demographics and patient-reported outcome measures
BTPB Autograft QT Autograft p-value
Age (years) 17.0±2.8 14.7±1.9 0.01
Sex (M/F) 13M / 22F 3M / 9F 0.44
Marx Activity Scale (0-16) 10.1±5.2 11.3±5.5 0.50
IKDC Score (0-100) 83.9±14.4 85.9±15.2 0.69
Graft Failure (N, %) 1 (2.8%) 0 (0.0%) N/A
BTB = bone – patellar tendon – bone; QT = quadriceps tendon; IKDC = International Knee Documentation Committee; M = male; F = female