Patient-Reported Knee Outcome Scores With Soft Tissue Quadriceps Tendon Autograft Are Similar to Bone-Patellar Tendon-Bone Autograft at Minimum 2-Year Follow-up: A Retrospective Single-Center Cohort Study in Primary Anterior Cruciate Ligament Reconstruction Surgery

Jose R Perez; Christopher P Emerson; Carlos M Barrera; Dylan N Greif; William H Cade 2nd; Lee D Kaplan; Michael G Baraga

doi:10.1177/2325967119890063

Patient-Reported Knee Outcome Scores With Soft Tissue Quadriceps Tendon Autograft Are Similar to Bone-Patellar Tendon-Bone Autograft at Minimum 2-Year Follow-up: A Retrospective Single-Center Cohort Study in Primary Anterior Cruciate Ligament Reconstruction Surgery

Orthop J Sports Med. 2019 Dec 17;7(12):2325967119890063. doi: 10.1177/2325967119890063. eCollection 2019 Dec.

Authors

Jose R Perez¹, Christopher P Emerson¹, Carlos M Barrera¹, Dylan N Greif¹, William H Cade 2nd¹, Lee D Kaplan¹, Michael G Baraga¹

Affiliation

¹ University of Miami Sports Medicine Institute, Coral Gables, Florida, USA.

Abstract

Background: Quadriceps tendon (QT)-bone autografts used during anterior cruciate ligament (ACL) reconstruction have provided comparable outcomes and decreased donor-site morbidity when compared with bone-patellar tendon-bone (BPTB) autografts. No study has directly compared the outcomes of the all-soft tissue QT autograft with that of the BPTB autograft.

Hypothesis: Patient-reported knee outcome scores and rates of postoperative complication after primary ACL reconstruction with QT autografts are no different from BPTB autografts at a minimum 2-year follow-up.

Study design: Cohort study; Level of evidence, 3.

Methods: A total of 75 patients who underwent primary autograft ACL reconstruction with QT or BPTB autografts between January 1, 2015, and March 31, 2016, at a single hospital center were contacted by telephone and asked to complete the International Knee Documentation Committee (IKDC) Subjective Knee Evaluation, Tegner activity level scale, and Lysholm knee scoring scale. Information about the subsequent surgeries performed on the operative knee was also collected. Statistical analysis was performed using the Kruskal-Wallis test and the Fisher exact test for categorical data.

Results: Fifty patients (28 QT, 22 BPTB) completed the surveys at a mean follow-up of 33.04 months (range, 24-44 months). For the QT versus the BPTB group respectively, the median IKDC scores were 94.83 (interquartile range [IQR], 7.61) versus 94.83 (IQR, 10.92) (P = .47), the median Tegner scores were 6 (IQR, 2.5) versus 6 (IQR, 2.75) (P = .48), and the median Lysholm scores were 95 (IQR, 9) versus 95 (IQR, 13) (P = .27). Additionally, 2 QT patients and 3 BPTB patients required follow-up arthroscopy for arthrolysis (P = .64). There was 1 graft failure in the QT group requiring revision surgery.

Conclusion: There was no statistical difference in patient-reported knee outcomes or graft complication rates between the QT and BPTB autograft groups at a minimum 2-year follow-up after primary ACL reconstruction. This study highlights that the all-soft tissue QT autograft may be a suitable graft choice for primary ACL reconstruction.

Keywords: all–soft tissue quadriceps tendon autograft; anterior cruciate ligament reconstruction; bone–patellar tendon–bone autograft; quad tendon anterior cruciate ligament.