Prospective study to assess functional outcomes in patients undergoing single bundle arthroscopic reconstruction of primary anterior cruciate ligament tear comparing with bone quadriceps tendon versus hamstring tendon autograft
DOI:
https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20201528Keywords:
Anterior cruciate ligament, Bone tendon quadriceps, Hamstring tendonAbstract
Background: Anterior cruciate ligament (ACL) injuries are one of the most common ligament injuries of knee. Arthroscopic ACL reconstruction has become the standard of care for ACL injuries in the active patient. In present study good bone quadriceps tendon (BQT) autograft and hamstring tendon (HT) autograft will be used for primary arthroscopic ACL reconstruction and its data regarding clinical and functional results will be evaluated and compared.
Methods: Sixty patients underwent isolated ACL reconstruction. 30 underwent ACL reconstruction with the BQT and 30 with the HT. The same surgical technique, fixation method and postoperative protocol were used in both groups. Functional outcome in terms of International Knee Documentation Committee (IKDC) score, joint stability (anterior drawer, Lachman, pivot shift), anterior knee pain and isokinetic strength was evaluated.
Results: IKDC score in bone quadriceps tendon and hamstring tendon group after 9 months follow up showing no statistical significance. The negative Lachman component was higher in the BQT group than in the HT group. There was no difference between groups in terms of isokinetic strength.
Conclusions: Our study shows no statistically significant difference between both groups.
References
Jenkins DB. Hollinshead's Functional Anatomy of the limbs and Back. Philadelphia: Harcourt Brace & Company, Jenkins; 1991: 233-239.
Kiapour AM, Murray MM. Basic science of anterior cruciate ligament injury and repair. Bone Joint Res. 2014;3:20-31.
Butler DL, Noyes FR, Grood ES. Ligamentous restraints to anterior-posterior drawer in the human knee. A biomechanical study. J Bone Joint Surg Am. 1980;62:259-70.
Kiapour AM, Wordeman SC, Paterno MV, Quatman CE, Levine JW, Goel VK, et al. Diagnostic value of knee arthrometry in the prediction of anterior cruciate ligament strain during landing. Am J Sports Med. 2014;42:312-9.
Cavaignac E, Coulin B, Tscholl P, Nik Mohd Fatmy N, Duthon V, Menetrey J. Is quadriceps tendon autograft a better choice than hamstring autograft for anterior cruciate ligament reconstruction? A comparative study with a mean follow-up of 3.6 years. Am J Sports Med. 2017;45:1326-32.
Fischer F, Fink C, Herbst E, Hoser C, Hepperger C, Blank C, Gföller P, et al. Higher hamstring-to- quadriceps isokinetic strength ratio during the first post- operative months in patients with quadriceps tendon compared to hamstring tendon graft following ACL reconstruction. Knee Surg Sports Traumatol Arthrosc. 2018;26(2):418-25.
Hart R, Kucera B, Safi A. Hamstring versus quadriceps tendon graft in double-bundle anterior cruciate ligament reconstruction. Acta Chir Orthop Traumatol Cech. 2010;77:296-303.
Joseph M, Fulkerson J, Nissen C, Sheehan TJ. Short-term recovery after anterior cruciate ligament reconstruction: A prospective comparison of three autografts. Orthopedics. 2006;29:243-8.
Kim SJ, Kumar P, Oh KS. Anterior cruciate ligament reconstruction: Autogenous quadriceps tendonebone compared with boneepatellar tendonebone grafts at 2- year follow-up. Arthroscopy. 2009;25:137-44.
Kim S-J, Lee S-K, Choi CH, Kim S-H, Kim S-H, Jung M. Graft selection in anterior cruciate ligament reconstruction for smoking patients. Am J Sports Med. 2013;42:166-72.
Todor A, Nistor DV, Caterev S. Clinical Outcomes after ACL reconstruction with free quadriceps tendon autograft versus hamstring tendon autograft. A retrospective study with a minimal follow-up two years. Acta Orthop et traumat Turica. 2019;53:180-93.
Akoto R, Albers M, Balke M, Bouillon B, Hohler J. ACL Reconstruction with Quadriceps tendon graft and Press-fit fixation versus quadruple hamstring graft and interference screw fixation - a matched pair analysis after one year follow up. BMC Musculoskeletal disorder. 2019;20:109.
