Summary

Return to play rates following ACL reconstruction with all soft tissue quadriceps tendon (QT) autograft were significantly higher than autograft quadriceps tendon with a bone block (QTB); however, there were no significant differences in knee outcome scores or revision rates between graft constructs.

Abstract

Purpose

To review and analyze the current literature on outcomes and impact of graft construct following anterior cruciate ligament reconstruction (ACL-R) with quadriceps tendon autograft. We aim to compare quadriceps tendon bone (QTB) versus all soft tissue quadriceps tendon (QT) graft options, including return to play, patient reported outcome scores, and complication rates.

Methods

A systematic review and meta-analysis were conducted by searching PubMed, Embase, SCOPUS, and Cochrane databases for studies published between 2003 and 2023, focusing on outcomes of quadriceps tendon autograft in ACL-R.

Results

37 studies with a total of 39 cohorts (n = 2,647) met inclusion criteria. The studies included 22 cohorts (n = 1,825 patients) for QTB and 17 cohorts (n = 822 patients) for QT. Patients who underwent ACL-R with QT graft demonstrated a significantly higher rate of return to play compared to those with a QTB (85.6% versus. 76.5%; p=0.0284). No statistical significance was found between IKDC Scores (p=0.5809), Lysholm Scores (p=0.8256), KOOS - Pain (p=0.3196), Post-Tegner Scores (p=0.9355), or revision rates (3.1% versus. 3.0%; p=0.8798) between graft constructs.

Conclusion

Our analysis demonstrates a significantly higher return to play rate in patients that underwent ACL reconstruction with a soft tissue QT versus QTB graft. No differences were found in patient reported outcome scores or revision rates.