Summary

This study was comparing quadriceps and hamstring autografts for anterior cruciate ligament (ACL) reconstruction.

Abstract

Anterior cruciate ligament (ACL) rupture has a high impact on the physical activity of productive-age population. Quadriceps tendon autograft is a better choice than hamstring tendon autograft for Asian population since Asian has smaller diameter and shorter length of hamstring tendon compared to other races. In this study, we evaluated the clinical outcome between quadriceps and hamstring autografts in arthroscopic-assisted ACL reconstruction. This was a prospective cohort study of 30 patients, who were divided into 2 groups: quadriceps and hamstring groups. The study was conducted from February 2016 until February 2017 at Gatot Subroto Army Hospital and Cipto Mangunkusumo Hospital, Jakarta. Treatment outcomes were assessed by using Rolimeter and scores of IKDC, Tegner-Lysholm and KOOS. Pearson chi square statistical test or Fischer exact test was used for proportional data. The student’s t test or Mann-Whitney U test was used for continuous numerical data. Functional outcomes were assessed before surgery, then at 1 month, 3 months and 6 months after surgery. Normality of the data was determined by Shapiro-Wilk test or Kolmogorov-Smirnov test (based on the sample size). At 6 months after surgery, knee joint stability of quadriceps group was significantly higher than that in hamstring group (3.12 ± 0.94 and 3.87 ± 0.61, respectively (p=0.015)). Side to side difference was better in quadriceps group (0.34 ± 0.70) compared to hamstring group (0.84 ± 0.60) (p=0.04). The IKDC scores of quadriceps group at 1 month post-surgery (p=0.002; CI95% [8.81-31.79]) and at 3 months post-surgery (p=0.004; CI95% [4.85-20.39]) were significantly better than that of hamstring group. The mean difference of numerical scale and categorical scale of Tegner-Lysholm assessment at 1 month post-surgery were significantly improved in quadriceps group (p<0.05). Significant improvements of KOOS pain scale (p=0.022) and KOOS symptoms scale (p=0.001) were observed at 3 months and 6 months post-surgery. In conclusion, based on objective and subjective evaluations, the functional outcomes of quadriceps group were significantly better than hamstring group.