Functional Outcomes of ACL Reconstruction with Tibialis Anterior Allograft, Hamstring or Quadriceps Tendon Autograft

Abstract

PURPOSE: The quadriceps index is a measure of the relative strength of the involved quadriceps compared to the uninvolved quadriceps. The purpose of this study was to investigate the changes in quadriceps strength in patients undergoing anterior cruciate ligament (ACL) reconstruction using anterior tibial tendon (ATT) allograft and hamstring tendon (HT) and quadriceps tendon (QT) autograft. METHODS: Fourteen patients (mean age: 26.8±5.8 years, BMI: 22.9±2.4 kg/m2) with ATT allograft and 15 patients (mean age: 27.1±5.4 years, BMI: 23.8±2.8 kg/m2) with HT autograft and 11 patients with QT autograft (mean age: 28.1±4.4 years, BMI: 22.6±3.8 kg/m2) were included in the study. All patients (n=40) were received the same reactive neuromuscular rehabilitation protocol after surgery. Quadriceps strength of the patients was measured at 60°/sec and 300°/sec angular speeds, using the Biodex System 3 (Biodex® Corp., Shirley, NY, USA). Functional outcomes of the lower extremity were measured with hop test and International Knee Documentation Committee Scoring System (IKDC) and the fear of movement was assessed with Tampa Kinesiophobia Scale. All measurements were applied at postoperative first year. Kruskall Wallis test was used for the comparison of variables between groups. RESULTS: The quadriceps indices were found similar at 60°/sec (p=0.308) and 300°/sec (p=0.716) angular speeds between the groups. There were no differences in IKDC (p=0.237) and fear of movement (p=0.059) scores between groups. CONCLUSIONS: Patients undergoing primary ACL reconstruction with ATT allograft, HT or QT autografts had satisfactory and similar objective and subjective clinical results. Functional rehabilitation would be the key factor to improve the functional status for different type of graft use in ACL reconstruction patients.