Purpose
To compare the 5-year clinical and functional outcomes of the soft-tissue quadriceps
tendon (QT) with those of the hamstring tendon (HT) autograft.
Methods
A retrospective review of patients undergoing anterior cruciate ligament reconstruction
using either soft-tissue QT or double-tendon HT autograft with at least 5 years of
follow-up was conducted. Surgical technique included anteromedial portal creation
for the femoral tunnel and transtibial technique for the tibia. Graft fixation was
achieved with interference composite screws for the QT and combination of interference
composite screw and suture button for the HT cohort. The 2 groups were compared for
differences in outcomes, including International Knee Documentation Committee (IKDC)
score, Lysholm score, return to sport, and complications.
Results
A total of 37 patients with QT autograft and 46 HT autografts were included in the
study, with a mean follow up of 69.9 months and 70.9 months, respectively. The QT
group demonstrated a larger graft size on average (9.64 mm vs 7.90 mm, P < .001). The IKDC and Lysholm scores were similar between the 2 groups at 2-years’
postoperatively. At 5 years’ postoperatively, the QT group demonstrated significantly
greater IKDC (P = .018) and Lysholm (P = .007) scores. The cohorts demonstrated similar rates of achieving minimal clinically
important difference thresholds at both 2 and 5 years’ postoperatively. The 2 groups
also demonstrated comparable rates of return to sport, time to return, and postoperative
complications.
Conclusions
Although the QT autograft demonstrated increased patient-reported outcome scores when
compared with the HT at 5 years’ postoperatively, there was no clinically significant
difference between the cohorts at 2 or 5 years’ postoperatively. The QT autograft
is an effective alternative to HT autograft with noninferior results to the HT autograft
at mid-term follow-up.
Level of Evidence
III, retrospective comparison study.
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Article info
Publication history
Published online: November 04, 2022
Accepted:
October 20,
2022
Received:
March 27,
2022
Footnotes
The authors report that they have no conflicts of interest in the authorship and publication of this article. ICMJE author disclosure forms are available for this article online, as supplementary material.
Identification
Copyright
© 2022 by the Arthroscopy Association of North America
