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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A Comparison of Lower Limb Strength and Plyometric Ability in Athletes who underwent ACLR with Lateral Extra-Articular Ilio-Tibial Band Tenodesis when compared with Isolated ACLR Surgery. A Biomechanical Study. Abstract Presentation 7 minutes Bláithín Brady, BSc MSc , IRELAND Sarah Crosbie, BSc, IRELAND Neil Welch, BSc MSc PhD, IRELAND Mihai Vioreanu, MD, MCh, FFSEM, FRCSI(Tr&Orth), IRELAND
Validation of a Risk Calculator to Personalize Graft Choice and Reduce Rupture Rates for Anterior Cruciate Ligament Reconstruction Abstract Presentation 6 minutes Hana Marmura, MPT, PhD, UNITED STATES Alan Getgood, MD, FRCS(Tr&Orth), DipSEM, QATAR Kurt Paul Spindler, MD, UNITED STATES Michael W Kattan, PhD, UNITED STATES Isaac Briskin, MA, UNITED STATES Dianne M. Bryant, PhD, CANADA
Comparison of three different Quadriceps Tendon ACL graft to BTB and Semi-T grafts: A biomechanical study ePoster Presentation Marc Jacob Strauss, MD, NORWAY Jonathan Miles, M.S, UNITED STATES Mitchell Iung Kennedy, BS, UNITED STATES Gilbert Moatshe, MD, PhD, NORWAY Grant J Dornan, MS, UNITED STATES Martin Lind, MD, PhD, Prof., DENMARK Lars Engebretsen, MD, PhD, NORWAY Robert F. LaPrade, MD, PhD, UNITED STATES
Increased Osteoarthritis And Knee Instability Following Postoperative Septic Knee Arthritis After Anterior Cruciate Ligament Reconstruction with a Minimum 8 Year Follow-Up ePoster Presentation Thomas R. Pfeiffer, Prof., GERMANY Julius Stüber, cand. med., GERMANY Jan-Hendrik Naendrup, BS, MD, GERMANY Daniel Guenther, MD, Prof., FACS, MHBA, GERMANY Robin Otchwemah, MD, GERMANY Sven T. Shafizadeh, Prof. Dr. , GERMANY Paola Kappel, MD, GERMANY Arasch Wafaisade, PD, GERMANY Sebastian Imach, MD, MBA, GERMANY
Changes In Muscle Strength And Hop Performance After ACL Reconstruction. A Randomized Controlled Trial Comparing Patellar Tendon And Hamstring Tendon Autografts With Standard Or Accelerated Rehabilitation Abstract Presentation 6 minutes Riccardo Cristiani, MD, PhD, SWEDEN Christina Mikkelsen, PT, SWEDEN Peter Olov Wange, MD, SWEDEN Daniel Olsson, PhD, SWEDEN Anders Stalman, MD, PhD, Professor, SWEDEN Bjorn Engstrom, MD, PhD, Assoc. Prof., SWEDEN
Predicting Subsequent Revision ACL Reconstruction: A Machine Learning Analysis of the Norwegian Knee Ligament Register Abstract Presentation 5 minutes R. Kyle Martin, MD, FRCSC, UNITED STATES Solvejg Wastvedt, BA, UNITED STATES Ayoosh Pareek, MD, UNITED STATES Andreas Persson, MD, PhD, NORWAY Havard Visnes, MD, PT, PhD, NORWAY Anne Marie Fenstad, MSc, NORWAY Gilbert Moatshe, MD, PhD, NORWAY Julian Wolfson, PhD, UNITED STATES Lars Engebretsen, MD, PhD, NORWAY
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
Quadriceps Tendon Autograft Has Lower MRI Signal Than Hamstring Tendon Autograft In Anterior Cruciate Ligament Reconstructions Of Adolescent Athletes Abstract Presentation 5 minutes David Alcoloumbre, MD, UNITED STATES Alexandra Hunter Aitchison, UNITED STATES Douglas Mintz, MD, UNITED STATES Frank A. Cordasco, MD, MS, UNITED STATES Daniel W. Green, MD, MS, UNITED STATES

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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