Arthroscopic anterior cruciate ligament reconstruction with quadriceps tendon autograft—minimal 4-year follow-up (SS-14)

Abstract

Surgical reconstruction of the anterior cruciate ligament (ACL) is indicated in the ACL-deficient knee with symptomatic instability and multiple ligaments injuries. In the present study, we describe the clinical results of quadriceps tendon-patellar bone autograft for ACL reconstruction. From 1996 to 1998, the graft has been used in 38 patients. Thirty-four patients with complete final follow-up for minimal 4 years were analyzed. The average follow-up time was 62 (48 to 84) months. Thirty-two (94%) patients achieved good or excellent results by Lysholm knee rating. Twenty-six (76%) patients could return to moderate or strenuous activity after reconstruction. Twenty-eight (82%) patients had ligament laxity of less than 2 mm. Finally, thirty-one (91%) patients were assessed as normal or nearly normal rating by IKDC guideline. Twenty-five (73%) patients had less than 10 mm difference in thigh girth between their reconstructed and normal limbs. Thirty-two (94%) and Thirty-one (91%) patients could achieve recovery of the extensor and flexor muscle strength in the reconstructed knee to 80% or more of normal knee strength respectively. A statistically significant difference exists in thigh girth difference, extensor strength ratio, and flexor strength ratio before and after reconstruction. Our study revealed satisfactory clinical subjective and objective results at minimal 4 years follow-up. Quadriceps tendon autograft has the advantage of being self-available, relatively easier arthroscopic technique, and having a suitable size, making it an acceptable graft choice for ACL reconstruction. There is little quadriceps muscle strength inhibition after quadriceps harvest. There is quicker return to sports with aggressive rehabilitation. A quadriceps tendon-patellar autograft is a reasonable adequate graft choice to ACL reconstruction.