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Early Return To Sport After Quadriceps Tendon Autograft ACL Reconstruction: Comparison To Bone-Patellar Tendon-Bone Autograft At A Minimum 1-Year Follow-Up

2021 Congress Paper Abstracts

Early Return To Sport After Quadriceps Tendon Autograft ACL Reconstruction: Comparison To Bone-Patellar Tendon-Bone Autograft At A Minimum 1-Year Follow-Up

Evan W. James, MD, UNITED STATES Dakota Adamec , BS , UNITED STATES Spencer Sullivan, BS, UNITED STATES Per-Henrik Randsborg , MD, PhD , UNITED STATES Brandon Schneider, MS, UNITED STATES Robert G. Marx, MD, UNITED STATES Answorth A. Allen, MD, UNITED STATES Frank A. Cordasco, MD, MS, UNITED STATES Benedict U. Nwachukwu, MD, MBA, UNITED STATES Danyal H. Nawabi, MD, FRCS(Orth), UNITED STATES

Hospital for Special Surgery, New York, NY, UNITED STATES


2021 Congress   ePoster Presentation     Not yet rated

 

Anatomic Location

Anatomic Structure

Diagnosis / Condition

Ligaments

ACL

Patient Populations

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Summary: Early return to sport rates after quadriceps tendon autograft ACL reconstruction are comparable to BTB autograft.


Introduction

Quadriceps tendon (QT) autograft for anterior cruciate ligament (ACL) reconstruction has been proposed as an alternative to bone-patellar tendon-bone (BTB) autograft in young, high-demand patients to achieve comparable clinical outcomes while avoiding complications associated with BTB autograft. However, few studies have reported patient satisfaction, rate of return to sport, rate of reinjury, level of participation, and psychological readiness for return to sport at early term follow-up.

Methods

All patients who underwent ACL reconstruction with either QT or BTB autograft between January 2018 and February 2020 were identified in a single institution registry. Patients were contacted at a minimum of 12-months post-surgery to evaluate patient satisfaction, rate of return to sport, rate of reinjury, level of sports participation, and psychological readiness for return to sport. Psychological readiness was determined using a six-item questionnaire adapted from the Anterior Cruciate Ligament-Return to Sport after Injury (ACL-RSI) scale.

Results

Thirty-seven QT patients (23 men, 14 women) with a mean age of 25.0 years (range, 14-45) who responded at an average follow-up of 15.3 months (range, 12.0-22.8) were compared to 73 BTB patients (38 men, 35 women) with a mean age of 22.8 (range, 14-40) who responded at an average follow-up of 17.2 months (range 12.0-23.5). Thirty-six of 37 (96%) QT patients compared to 70 of 73 (96%) BTB patients reported being either very satisfied or somewhat satisfied with surgery results. There were 21 of 37 (56%) QT patients compared to 40 of 73 (55%) BTB patients who returned to sport participation. Among patients who returned to sport, 14 of 21 (67%) QT patients versus 27 of 40 (68%) BTB patients participated at the same level of competition or higher as compared to before injury. Among QT patients who did not return, the following reasons were cited: lack of clearance (2 of 16, 13%), fear of reinjury (4 of 16, 25%), physical limitations (5 of 16, 31%), and other reasons (5 of 16, 31%). Among BTB patients who did not return, the following reasons were cited: lack of clearance (7 of 33, 21%), fear of reinjury (6 of 33, 18%), physical limitations (7 of 33, 21%), other reasons (11 of 33, 33%), and no reason (2 of 33, 6%). Mean ACL-RSI scale score was significantly higher 77.4 ± 22.5 in QT patients who returned to sport compared to those who did not 46.6 ± 22.2 (P < 0.0001). Similarly, mean ACL-RSI scale score was significantly higher 72.5 ± 21.3 in BTB patients who returned to sport compared to those who did not 38.4 ± 24.8 (P < 0.0001). One QT patient and two BTB patients required revision ACL reconstruction due to retear.

Conclusion

Satisfaction with outcome was high for both groups. Return to sport rates for QT and BTB patients were nearly identical at early follow-up. Psychological readiness for return to sport was significantly lower in QT and BTB patients who did not return to sport, suggesting psychological limitations may contribute to inability to return to sport at early follow-up.


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