The impact of graft type on rehabilitation outcomes following ACL reconstruction: Bone patellar tendon bone versus quadriceps tendon grafts

Abstract

ObjectiveThe aims of this study were to 1) compare the dosage of physical therapy provided for patients following an anterior cruciate ligament reconstruction (ACL-R) with either quadriceps or bone-patellar tendon-bone (BPTB) graft type and their resulting outcomes and 2) investigate the frequency therapists documented surgical graft type. DesignRetrospective observational. SettingOutpatient orthopedics. ParticipantsData was collected from the electronic medical records of 212 patients: BPTB (41) and quadriceps tendon (33) were analyzed. Forty-eight cases were other graft types and 90 were unspecified. Main outcome measureAn independent samples t-test was used to compare differences in knee range of motion (ROM) and Knee Functional Status (FS) between BPTB and quadriceps grafts. ResultsThere were no differences in knee flexion (p = 0.148) or extension (p = 0.305) ROM between groups at discharge. The quadriceps group achieved greater improvement in functional outcomes (p < 0.001). The quadriceps group received more sessions (p = 0.021) and a longer duration of care (p = 0.007). ConclusionsThe significant difference in treatment dosage makes it difficult to conclude which graft is superior. It is unknown if the frequent omission of graft type in the patient chart is an indication of poor documentation practice or a lack of perceived importance in knowing the graft type for PT.