Summary: One of the most common complications in anterior cruciate ligament reconstructions is high donor site morbidity. We propose that contralateral quadriceps graft could be a reasonable option especially in patients that have poor tolerance to pain and need to return to work sooner.

Introduction

One of the most common complications in anterior cruciate ligament reconstructions is high donor site morbidity and postoperative pain, which is often associated with difficulties in the restoration of motion and delayed return to daily activities.
The objective of this paper is to compare postoperative pain, time to return to daily activities, and other clinical outcomes, in two groups of patients undergoing primary ACL reconstructions with autologous bone-quadriceps tendon (BQT) graft from the ipsilateral or contralateral knee.
We propose that contralateral BQT could be a reasonable option especially in patients that have poor tolerance to pain and need to return to work sooner.

Methods

Patients with primary ACL reconstruction using autogenous BQT graft were non-randomized and prospectively evaluated. Patients were given the choice of where to obtain the graft from, either from the ipsilateral knee (injured) or from the contralateral knee (healthy). It was explained to the patients that, according to our experience, patients operated on with contralateral knee graft suffered less pain in the immediate postoperative period, because the surgical trauma was divided between the two knees and that they could have a sooner return to daily activities or light work. It was also explained to the patients that, as a disadvantage, a totally healthy knee was being operated on, with possible surgical complications.

The inclusion criteria were isolated ACL tears, less than one year from injury to surgery, use of an autologous quadriceps tendon graft, and correct follow-up. Patients with associated ligament injuries, meniscal repairs, Outerbridge II or higher osteochondral injuries, patellofemoral pathology, and revision surgeries were excluded.
We evaluated postoperative pain, the amount of analgesics consumed, time to full range of motion, and time to return to activities of daily living and sport activities.

Results

Seventy-eight patients with primary ACL reconstruction using autogenous BQT graft were prospectively evaluated. In 34 patients (Group A) the graft was obtained from the ipsilateral knee, in the others 44 patients (Group B) the graft was obtained from the contralateral knee.
Patients in Group B had less postoperative pain than Group A (1,8 ± 0,6 - 3,1 ± 0,6 - p < 0,0001) consumed less amount of pain medication (p<0,0001) , and re-established flexion and extension faster than those with ipsilateral graft harvest (P < 0,0001). Group B patients also returned earlier to their daily activities (26.5 ± 15.3 days) than those in Group A (37 ± 11.42 days) (p < 0.0001). Patients in group B return to work sooner than group A (Graph 3). There was no difference in time to return to sport.

Conclusions

Patients operated with contralateral quadriceps tendon graft have less postoperative pain, achieve earlier full mobility, consume less pain medication post-operatively, and return faster to activities of daily living and work than those undergoing ipsilateral graft harvest. We think contralateral harvest of BQT graft is an excellent choice especially for patients who have poor pain tolerance and in those in which a quicker return to their activities of daily living or work is a priority.

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Quantitative Evaluation of Lateral Articular Cartilage Quality on Magnetic Resonance Imaging at 2-years following Anterior Cruciate Ligament Reconstruction With Or Without A Lateral Extra-Articular Tenodesis Abstract Presentation 6 minutes Andrew Firth, PhD, CANADA Dianne M. Bryant, PhD, CANADA Jaques Milner , CANADA Stephany Pritchett, MD, FRCPC, DABR, CANADA David Holdsworth, PhD, Canada Stability Study Group, CANADA Alan Getgood, MD, FRCS(Tr&Orth), DipSEM, QATAR
Early ROM exercise after ACLR with hamstring autograft does not cause joint laxity : A Prospective Randomized Controlled Trial, 2 years follow up ePoster Presentation Jeong-Ku Ha, MD, phD, Prof, KOREA, REPUBLIC OF Kyu Sung Chung, MD, PhD, Prof., KOREA, REPUBLIC OF
In Vivo Measurement of Anterior Cruciate Ligament Elongation and Strain Rate during Increasingly Demanding Activities ePoster Presentation Kyohei Nishida , MD, PhD, JAPAN Caiqi Xu, MD, CHINA Tom Gale, MS, UNITED STATES William Anderst, PhD, UNITED STATES Freddie H. Fu, MD, UNITED STATES
Ligamentous Laxity, Male Sex, Chronicity, Meniscus Injury And Posterior Tibial Slope Are Associated With A High-Grade Pre-Operative Pivot Shift: A Post Hoc Analysis Of The Stability Study Abstract Presentation 6 minutes Lachlan Batty, FRACS, AUSTRALIA Andrew Firth, PhD, CANADA Gilbert Moatshe, MD, PhD, NORWAY Dianne M. Bryant, PhD, CANADA S. Mark A. Heard, MD, FRCS, CANADA Robert G. McCormack, MD, CANADA Alex Rezansoff, MD, FRCSC, CANADA Devin Clarke Peterson, MD, FRCSC, Dip Sport Med, CANADA Davide Bardana, MD, CANADA Peter B. MacDonald, MD, FRCS, Dip Sport Med, CANADA Tim Spalding, FRCS(Orth), UNITED KINGDOM Alan Getgood, MD, FRCS(Tr&Orth), DipSEM, QATAR
Comparative Study Of “Concomitant Patellar Tendon Rupture With Anterior cruciate ligament tear and Patellar Tendon Rupture With Multi- Ligamentous Knee Injury –MLKI” Abstract Presentation 6 minutes Silvampatti Ramasamy Sundararajan, MS(Orth), INDIA Rajagopalakrishnan Ramakanth, D.ortho, DNB(ortho), D.SICOT, INDIA S Rajasekaran, MS(Orth),DOrth,DNB,FRCS(Ed),FRCS(Lon),MCh(Liv),PhD, INDIA
Impingement Due to Graft Buckling Is More Prevalent after ACL Reconstructions with an Adjustable-Loop Compared to a Fixed-Loop Abstract Presentation 5 minutes Julian De Rover, NETHERLANDS Inge Van Den Akker-Scheek, PhD, NETHERLANDS Hugo Christiaan van der Veen, MD, PhD, NETHERLANDS
Inter- and Intra-Rater Reliability of Measurenebt of ACL TUnnels with Radiographs, CT, and MRI Abstract Presentation 4 minutes Robert A Magnussen, MD, MPH, UNITED STATES Alexander Sparks, BS, UNITED STATES Jacy Leon, BS, UNITED STATES Matthew Colatruglio, BS, UNITED STATES Joshua Bowler, MD James Oosten, BS, UNITED STATES Alex C. Dibartola, MD, MPH, UNITED STATES Joshua Scott Everhart, MD, MPH, UNITED STATES Robert A. Duerr, MD, UNITED STATES Christopher C. Kaeding, MD, UNITED STATES David C. Flanigan, MD, UNITED STATES
Why, When and Who Fails Non-Operative Treatment of Anterior Cruciate Ligament Injury – An Exploratory Analysis of the COMPARE Trial Abstract Presentation 5 minutes Sabine van der Graaff, MD, NETHERLANDS Duncan E. Meuffels, MD, PhD, Prof., NETHERLANDS Sita Bierma-Zeinstra, MD, NETHERLANDS Eline van Es, MSc, NETHERLANDS Jan Verhaar, MD, PhD, Prof., NETHERLANDS Vincent Eggerding, MD, NETHERLANDS Max Reijman, PhD, NETHERLANDS
Bone Marrow Aspiration Concentrate Augmentation in Anterior Cruciate Ligament Hamstring Autograft Reconstruction: Clinical and Functional Outcomes of a Cohort Study Abstract Presentation 5 minutes David H. Figueroa, MD, CHILE Rodrigo Guiloff, MD, Prof, CHILE Sergio Arellano, MD, CHILE Alex Vaisman, MD, Prof., CHILE Francisco Figueroa, MD, CHILE Nicolas Zilleruelo, MD, CHILE Rafael Calvo, MD, CHILE

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Contralateral versus ipsilateral quadriceps graft, for anterior cruciate ligament reconstruction.

Contralateral versus ipsilateral quadriceps graft, for anterior cruciate ligament reconstruction.

Introduction

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Contralateral versus ipsilateral quadriceps graft, for anterior cruciate ligament reconstruction.

Contralateral versus ipsilateral quadriceps graft, for anterior cruciate ligament reconstruction.

Introduction

Methods

Results

Conclusions

More ISAKOS 2021: Global Content