ACL Reconstruction: Clinical and Functional Outcomes in Quadricep Tendon Grafts Versus Hamstring Tendon Grafts
- Kitchens C. ,
- Kurka O. and
- Wattenbarger C.
- Kitchens C. ,
- Kurka O. and
- Wattenbarger C.
2024
Repository
Description
Background: Anterior cruciate ligament (ACL) injuries are among the most common
ligamentous injuries and often require surgical repair. ACL reconstruction (ACLR) is performed
using bone-patella tendon-bone (BPTB) autografts, hamstring tendon (HT) autografts,
quadriceps tendon (QT) autografts, or various allografts. HT and BPTB autografts have been the
most common grafts used historically. However, QT graft usage has risen in popularity in recent
years. There have been studies comparing the different grafts but there has been conflicting
evidence of which graft is superior, especially when comparing QT and HT grafts.
Purpose: This research sought to determine whether a QT or HT graft is superior in ACLR and
to derive an algorithm for clinicians.
Methods: A systematic literature search was conducted in PubMed, CINAHL, and MedlinePlus
from December 2023 to February 2024. Titles, abstracts, and full-text articles were screened
using a set of criteria. Articles that passed each criterion were assessed with a quality assessment
tool and only accepted if they were of “good” quality. The research was limited to 3 “good”
quality studies. Data extraction was performed using a data extraction tool to present findings at
a descriptive and thematic level.
Results: A total of 3 studies were included: 1 randomized control trial and 2 cohort studies. The
total patient population was 235 (range 50-99) and all participants were 18 years old or older.
There were no significant differences in International Knee Documentation Committee (IKDC),
pivot shift, rupture rates, and Tegner activity scores between the QT and HT groups in the 3
studies. Significant differences between the groups in favor of QT grafts were found in 1 study.
These differences were in KT-1000 (P=.037), Knee Injury and Osteoarthritis Outcome Score
(KOOS) symptoms (P=.017), KOOS sports (P=.003), and Lysholm scores (P=.008). A different
v
study reported a significant decrease in donor site morbidity in the QT group at 1-year (P=.03)
and 2-year (P=.046) follow-ups.
Conclusion: The researchers were unable to conclude that QT grafts led to better clinical and
functional outcomes over HT grafts in ACLR. The research suggests that the pair of grafts yield
comparable outcomes. It appears that choosing between a QT and HT graft is greatly determined
by the surgeon's preference rather than the features of a graft. Further research is needed to create
an algorithm for clinicians.
Show Full Abstract
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ligamentous injuries and often require surgical repair. ACL reconstruction (ACLR) is performed
using bone-patella tendon-bone (BPTB) autografts, hamstring tendon (HT) autografts,
quadriceps tendon (QT) autografts, or various allografts. HT and BPTB autografts have been the
most common grafts used historically. However, QT graft usage has risen in popularity in recent
years. There have been studies comparing the different grafts but there has been conflicting
evidence of which graft is superior, especially when comparing QT and HT grafts.
Purpose: This research sought to determine whether a QT or HT graft is superior in ACLR and
to derive an algorithm for clinicians.
Methods: A systematic literature search was conducted in PubMed, CINAHL, and MedlinePlus
from December 2023 to February 2024. Titles, abstracts, and full-text articles were screened
using a set of criteria. Articles that passed each criterion were assessed with a quality assessment
tool and only accepted if they were of “good” quality. The research was limited to 3 “good”
quality studies. Data extraction was performed using a data extraction tool to present findings at
a descriptive and thematic level.
Results: A total of 3 studies were included: 1 randomized control trial and 2 cohort studies. The
total patient population was 235 (range 50-99) and all participants were 18 years old or older.
There were no significant differences in International Knee Documentation Committee (IKDC),
pivot shift, rupture rates, and Tegner activity scores between the QT and HT groups in the 3
studies. Significant differences between the groups in favor of QT grafts were found in 1 study.
These differences were in KT-1000 (P=.037), Knee Injury and Osteoarthritis Outcome Score
(KOOS) symptoms (P=.017), KOOS sports (P=.003), and Lysholm scores (P=.008). A different
v
study reported a significant decrease in donor site morbidity in the QT group at 1-year (P=.03)
and 2-year (P=.046) follow-ups.
Conclusion: The researchers were unable to conclude that QT grafts led to better clinical and
functional outcomes over HT grafts in ACLR. The research suggests that the pair of grafts yield
comparable outcomes. It appears that choosing between a QT and HT graft is greatly determined
by the surgeon's preference rather than the features of a graft. Further research is needed to create
an algorithm for clinicians.
Subjects
Record Data:
- Program:
- Physician Assistant Studies
- Location:
- Knoxville
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