The right choice of graft in anterior cruciate ligament (ACL) reconstruction is still under discussion. The hamstrings are currently the most utilized grafts for primary ACL reconstruction in Europe. However, there has been an increase in interest in the quadriceps tendon (QT) as an alternative autologous graft option for primary ACL reconstruction.
To evaluate the knee stability and subjective outcome after ACL reconstruction using either autologous quadriceps (QT) in implant free femoral press-fit fixation technique or semitendinosus tendon (ST).
Study design: Cohort study
We evaluated a total of 50 patients who underwent ACL reconstruction – including 25 with autologous ipsilateral QT graft (group I) and 25 patients using the ipsilateral ST (group II). The follow-up for this prospective comparative study was at least two years after surgery, comprising KT1000 arthrometer testing, pivot shift test, Knee Injury Osteoarthritis Outcome Score (KOOS), Lysholm score and re-rupture rate.
The mean age in group I was 31.72 respectively 32.08 years in group II with a sex distribution of female : male of 9 : 16 in group I and 13:12 in group II. The mean postoperative side-to-side difference assessed by KT1000 arthrometer was 1.56 ± 1.56 mm for group I and 1.64 ± 1.41mm for group II with no significant difference. There was no significant difference in the individual KOOS subscores (p=0.694). The mean Lysholm score was 88.60 ± 11.78 in group I and 86.28 ± 15.72 in group II (p=0.682). No re-rupture or positive pivot-shift test occurred during follow-up. There was no difference in donor side morbidity for both groups.
QT as well as ST are both equal regarding their clinical outcome. Thus, the QT may serve as a good alternative graft for primary ACL reconstruction.
Key Terms: ACL reconstruction, hamstrings, quadriceps tendon, press-fit technique