Quadriceps tendon autograft for primary anterior cruciate ligament reconstruction in comparison to hamstring tendon autografts

Abstract

Purpose One of the pillars of successful anterior cruciate ligament (ACL) reconstruction is the choice of the ideal graft substitute. The central one-third of the quadriceps tendon is apparently a good autograft option, representing a modular reconstructive option with minimal donor site morbidity. The aim of this research is to compare the functional outcome of primary ACL reconstruction using quadriceps tendon autografts in comparison to the hamstring tendon autograft. Patients and methods This prospective, randomized clinical study included 60 patients with torn ACL randomly divided into group I (the control group), whereby ACL reconstruction was performed using the hamstring tendon autograft or group II (the study group), whereby ACL reconstruction was done using the central part of quadriceps tendon pure soft tissue autograft. The study was performed in our hospital between January 2016 and March 2018. The mean follow-up period was 2.2 ± 0.4 years. Assessment was done clinically using the IKDC 2000 subjective and objective scoring system. Objective laxity measurements were performed using the KT-1000 at the end of follow-up. Results Clinical assessment of the patients in the 6th month postoperatively and at the end of follow-up averaged 2.2 ± 0.4 years according to the IKDC 2000 Subjective and Objective Scoring System and revealed significantly better results for group II in early postoperative after 6 months, with comparable results at the end of follow-up. Objective laxity measurements at the end of follow-up revealed that the side-to-side difference is a little bit better in the quad group with no statistically significant results. Conclusion The central part of the quadriceps tendon is a viable autograft option for primary ACL reconstruction with good mid-term functional results, and minimal donor site morbidity as compared with the standard most commonly used hamstring tendon autograft; however, a longer term and multicenter studies are still needed to validate its routine use.