Evaluation of functional outcome of arthroscopic isolated anterior cruciate ligament reconstruction with quadriceps tendon

M. Saklayen Hossain; Abu Z. Chowdhury; Chowdhury I. Mahmud; Silvia Hossain; M. Shamsul Alam

doi:10.18203/issn.2455-4510.IntJResOrthop20243887

Authors

M. Saklayen Hossain Department of Orthopaedic Surgery, National Institute of Traumatology and Orthopedic Rehabilitation (NITOR), Dhaka, Bangladesh
Abu Z. Chowdhury Department of Orthopaedic Surgery, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
Chowdhury I. Mahmud Department of Orthopaedic Surgery, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
Silvia Hossain Department of Gynecological Oncology, National Institute of Cancer Research and Hospital (NICRH), Dhaka, Bangladesh
M. Shamsul Alam Department of Orthopaedic Surgery, National Institute of Traumatology and Orthopedic Rehabilitation (NITOR), Dhaka, Bangladesh

DOI:

https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20243887

Keywords:

Anterior cruciate ligament reconstruction, Quadriceps tendon, Lysholm score, Visual analogue scale

Abstract

Background: The anterior cruciate ligament (ACL) is one of the most important intra-articular ligaments in the knee joint. It is regarded as the main barrier preventing the tibia from anteriorly translating onto the femur. The greatest incidence occurs in 15 to 25-year-old participants of work and pivoting sports. This study aimed to assess the functional outcome of arthroscopic isolated ACL reconstruction with quadriceps tendon.

Methods: This was a prospective interventional study conducted in the Department of Orthopaedic Surgery, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh during the period from March 2020 to August 2022. In our study, we included 30 patients with anterior cruciate ligament injuries who attended the orthopaedic department within the study period.

Results: The preoperative Lysholm score was found to be poor in all cases. Nine months after arthroscopic isolated ACL reconstruction with quadriceps tendon Lysholm score was found as excellent in 18 (60%) cases, good in 8 (26.7%), and fair in 4 (13.3%) cases. During the last follow-up of 9 months after arthroscopic isolated ACL reconstruction with quadriceps tendon, 26 (86.7%) patients were found as satisfactory results, and only 4 (13.3%) patients were found as unsatisfactory. A significant difference was observed between preoperative and postoperative functional outcomes.

Conclusions: In our study, we found that arthroscopic isolated ACL reconstruction with quadriceps tendon showed satisfactory functional outcomes for the treatment of ACL injury, and all the functions of the knee were improved in compared with their pre-operative status.

Metrics

Metrics Loading ...

References

Sharma S, Joshi G, Philip VM, Kaushal N. Arthroscopic anterior cruciate ligament reconstruction with central quadriceps tendon-bone (CQTB) graft: An outcome study in fifty Indian patients. Int J Res Med Sci. 2017;5:4506-11.

Mohtadi N, Chan D, Barber R, Paolucci BEO. A randomized clinical trial comparing patellar tendon, hamstring tendon, and double-bundle ACL reconstructions: Patient-reported and clinical outcomes at a minimal 2-year follow-up. Clin J Sport Med. 2015;25:321-31.

Ashford WB, Kelly TH, Chapin RW, Xerogeanes JW, Slone HS. Predicted quadriceps vs. quadrupled hamstring tendon graft size using 3-dimensional MRI. Knee. 2018;25(6):1100-6.

Shelton WR, Fagan BC. Autografts commonly used in anterior cruciate ligament reconstruction. J Am Acad Orthop Surg. 2011;19(5):259-64.

Nwachukwu BU, McFeely ED, Nasreddine A. Arthrofibrosis after anterior cruciate ligament reconstruction in children and adolescents. J Pediatr Orthop. 2011;31(8):811-7.

Vairo GL, McBrier NM, Miller SJ, Buckley WE. Premature knee osteoarthritis after anterior cruciate ligament reconstruction dependent on autograft. J Sport Rehabil. 2010;19(1):86-97.

Sajovic M, Vengust V, Komadina R, Tavcar R, Skaza K. A prospective, randomized comparison of semitendinosus and gracilis tendon versus patellar tendon autografts for anterior cruciate ligament reconstruction: Five-year follow-up. Am J Sports Med. 2006;34(12):1933-40.

Gifstad T, Foss OA, Engebretsen L. Lower risk of revision with patellar tendon autografts compared with hamstring autografts: A registry study based on 45,998 primary ACL reconstructions in Scandinavia. Am J Sports Med. 2014;42(10):2319-28.

Xie X, Liu X, Chen Z, Yu Y, Peng S, Li Q. A meta-analysis of bone-patellar tendon-bone autograft versus four-strand hamstring tendon autograft for anterior cruciate ligament reconstruction. Knee. 2015;22(2):100-10.

Samuelsen BT, Webster KE, Johnson NR, Hewett TE, Krych AJ. Hamstring autograft versus patellar tendon autograft for ACL reconstruction: Is there a difference in graft failure rate? A meta-analysis of 47,613 patients. Clin Orthop Relat Res. 2017;475(10):2459-68.

Lavery KP, Rasmussen JF, Dhawan A. Five-strand hamstring autograft for anterior cruciate ligament reconstruction. Arthroscopy. 2014;3(4):423-6.

Magnussen RA, Lawrence JTR, West RL. Graft size and patient age are predictors of early revision after anterior cruciate ligament reconstruction with hamstring autograft. Arthroscopy. 2012;28(4):526-31.

Cavaignac E, Coulin B, Tscholl P, Fatmy NNM, 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;20(10):1-8.

Jennifer L, Hunnicutt JL, Slone HS, Xerogeanes JW. Implications for early postoperative care after quadriceps tendon autograft for anterior cruciate ligament reconstruction: A technical note. J Athl Train. 2020;55(6):623-7.

Todor A, Nistor DV, Caterev S. Clinical outcomes after ACL reconstruction with free quadriceps tendon autograft versus hamstring tendons autograft. A retrospective study with a minimal follow-up of two years. Acta Orthop Traumatol Turc. 2019;53(3):180-3.

Sofu H, Sahin V, Gürsu S, Yıldırım T, Issın A, Ordueri M. Use of quadriceps tendon versus hamstring tendon autograft for arthroscopic anterior cruciate ligament reconstruction: a comparative analysis of clinical results. Eklem Hastalik Cerrahisi. 2013;24(3):139-43.

Akoto R, Albers M, Balke M, Bouillon B, Höher 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 Musculoskelet Disord. 2019;20(1):109.

Devana SK, Solorzano C, Nwachukwu B, Jones KJ. Disparities in ACL Reconstruction: the Influence of Gender and Race on Incidence, Treatment, and Outcomes. Curr Rev Musculoskelet Med. 2022;15(1):1-9.

Khanna G, Attri R, Sharma R. 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. Int J Orthop. 2020;6:511-4.

Courtot L, Ferre F, Reina N, Marot V, Chiron P, Berard E, et al. Patient participation during anterior cruciate ligament reconstruction improves comprehension, satisfaction, and functional outcomes: a simple way to improve our practices. Orthop J Sports Med. 2019;7(4):2325967119841089.

Galan H, Escalante M, Della Vedova F, Slullitel D. All inside full thickness quadriceps tendon ACL reconstruction: Long term follow-up results. J Exp Orthop. 2020;7(1):13.