2017 ISAKOS Biennial Congress ePoster #1151

 

Quadriceps versus Hamstring Tendon Autografts for Primary Anterior Cruciate Ligament Reconstruction

Armin Runer, PD MD, Munich GERMANY
Guido Wierer, MD, Salzburg AUSTRIA
Elmar Herbst, MD, PhD, Muenster GERMANY
Caroline Hepperger, PhD, Innsbruck AUSTRIA
Mirco Herbort, MD, Prof., Munich GERMANY
Peter Gföller, MD, Innsbruck AUSTRIA
Christian Hoser, MD, Innsbruck AUSTRIA
Christian Fink, MD, Prof., Innsbruck AUSTRIA

Gelenkpunkt , Innsbruck, AUSTRIA

FDA Status Not Applicable

Summary

QT and HT autografts show good and comparable patient-reported functional outcomes making the quadriceps tendon a reliable graft alternative to hamstring tendons for primary ACL reconstruction

ePosters will be available shortly before Congress

Abstract

Introduction

Graft choice for anterior cruciate ligament (ACL) reconstruction is crucial, however the optimal graft source remains a topic of controversy. Lately the quadriceps tendon (QT) autograft is getting more attention also in primary ACL surgery by showing potential advantages in areas where traditional grafts show weaknesses.

Purpose

To compare subjective and functional patient-reported outcomes (PRO) after single bundle ACL reconstruction using quadriceps tendon (QT) or hamstring tendon (HT) autografts.

Study Design: Cohort study

Methods

All data were extracted from a prospectively-collected ACL registry. 80 patients with at least two years follow–up were included in this study. 40 patients with primary ACL reconstruction using a QT autograft harvested via a minimally invasive technique were matched by sex, age, and pre-injury Tegner and Lysholm score to 40 patients who received HT autografts. Subjective and functional PRO scores including Lysholm score, Tegner activity level and visual analogue scale for pain (VAS) were obtained at 6, 12 and 24 months after index surgery.

Results

Both groups were similar in respect to gender, age, preinjury Tegner score, preinjury Lysholm score, injury–to–surgery time as well as concomitant meniscal, collateral and chondral injuries.
No significant difference between the QT and the HT group was seen at any follow - up in regards to any of the PRO scores for function or pain.
Within the groups no significant difference in the Tegner activity score was observed at 6 and 12 months after surgery compared to the pre-injury level. At 24 months postoperatively, the mean Tegner activity score in the HT group was significantly lower (p=.04) compared to pre-injury status. At final follow–up, 67.5% (n = 27) of patients in the QT group and 80.0% (n = 32) of patients in the HT returned to their pre-injury activity level. (p=n.s.)
92.5% of the QT cohort and 87.5% of the HT cohort reported “good” or “excellent” results according to the Lysholm score.(p=n.s.) “No pain” or “slight pain” during severe exertion was reported by 82.5% (n=33) of the patients with QT autograft and 82.4% (n=28) of the patients with HT autograft.(p=n.s.) Throughout the two years of follow-up, one graft rupture occurred in the HT group while no re-ruptures were registered in the QT group.

Conclusion

QT and HT autografts demonstrate comparable patient-reported functional outcomes. These findings suggest that quadriceps tendon is a reliable graft alternative to hamstring tendons for primary ACL reconstruction.

Key Words: Quadriceps tendon, hamstring tendon, anterior cruciate ligament, ACL reconstruction, patient reported outcome