Summary
Quadriceps tendon graft based ACL reconstruction outcome is no affected by the quadriceps tendon graft is with or without a bone block
Abstract
Background
Quadriceps tendon (QT) has recently gained increased interest as ACL reconstruction (ACLR) graft due to the introduction of minimal invasive harvesting techniques and low donor site morbidity. QT grafts can be used either with patella bone block or as complete soft tissue graft. It is unknown whether QT graft type affects clinical outcomes.
Aim
The purpose of the present study was to use the Danish Knee Ligament Reconstruction Registry (DKRR) to compare revision rates, knee stability and subjective clinical outcomes in patients who underwent ACLR with QT graft with (QT-B) and without block (QT-S).
Methods
Inclusion criteria were primary ACL reconstruction with QT autograft in DKRR. Two study populations were identified based on QT graft type for ACL reconstruction: patients with QT-B (n = 925); and patients with QT-S (n = 659).
Clinical outcome was evaluated by revision rates for the two cohorts. Objective instrumented knee stability and pivot shift tests were performed at one-year follow-up as well as KOOS and Tegner Activity scale scores.
Results
The revision rate at 2 years was similar in both groups at 2.8 %. Postoperative knee laxity was equal between QT-B and QT-S ACLR with 1.5 and1.6 mm side-to-side laxity respectively. QT-B had a 22 % incidence of postoperative positive pivot shift compared to 29 % for QT-S. Subjective outcome was similar for KOOS and Tegner Activity scale scores at one year, but with reduced improvements for KOOS symptoms and KOOS sport for QT-B compared to QT-S.
Conclusion
ACL reconstructions with QT autograft with a bone block or as a complete soft tissue graft resulted in similar low revision rates and achieved similar good sagittal knee stability. A secondary finding was that ACL reconstructions with QT graft with a bone block obtained better rotational stability than ACL reconstructions with complete soft tissue QT grafts.