scholarly journals 724 Quadriceps Tendon Autograft Versus Hamstring Tendon Autograft in Anterior Cruciate Ligament Repair: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
T K Tan ◽  
A G Subramaniam ◽  
R Radic
Keyword(s):  
Anterior Cruciate Ligament ◽  
Observational Studies ◽  
Cruciate Ligament ◽  
Meta Analysis ◽  
Quadriceps Tendon ◽  
Peak Torque ◽  
Hamstring Tendon ◽  
Pivot Shift Test ◽  
Anterior Cruciate ◽  
Tendon Autograft

Abstract Aim Quadriceps tendon (QT) autograft has recently become the popular choice of autograft in anterior cruciate ligament reconstruction (ACLR) and slowly replacing hamstring tendon (HT) autograft. QT autograft has traditionally served as the alternative of HT autograft, but recent studies revealed that QT autografts are not inferior to HT autografts. The purpose of this study was to provide an in-depth review the clinical and functional outcomes between QT and HT autografts in ACLR. Method Databases of Pubmed, EMBASE, MEDLINE and CENTRAL were systematically searched from its inception until November 2020. All observational studies comparing QT and HT autografts in the ACRL surgery were included. Results Twenty-two observational studies (3 randomized controlled trials and 19 comparative studies) comprising of 16952 patients (QT = 1407, HT = 15545) were included in quantitative meta-analysis. In comparison to HT autograft, patients who received QT autograft had similar postoperative Lysholm Score (MD:1.05, p = 0.44), Tegner Score (MD:0.11, p = 0.06), IKDC score (MD:0.48, p = 0.48), side to side laxity(MD:-0.08, p = 0.77), limb symmetry index (MD:1.87, p = 0.61), Pivot shift test grade 0 (OR:1.13, p = 0.74), Lachman test grade 0 (OR:2.38, p = 0.32), hamstring to quadriceps ratio (MD:-1.10, p = 0.82), incidence of graft failure (OR:0.68, p = 0.43), contralateral knee injury (OR:1.22, p = 0.61), peak torque muscle strength flexion (MD:-0.20, ρ = 0.10) and Cincinnati score (MD:-0.85, p = 0.66). Conclusions In this meta-analysis, the usage of QT autograft is not inferior to HT autograft in ACLR. Our study demonstrated comparable morbidity, clinical and functional outcome in QT and HT autografts, indicating that QT autograft is equally safe as HT autograft.

MRI Signal Intensity of Quadriceps Tendon Autograft and Hamstring Tendon Autograft 1 Year After Anterior Cruciate Ligament Reconstruction in Adolescent Athletes

2021 ◽  
pp. 036354652110404
Author(s):  
Alexandra H. Aitchison ◽  
David Alcoloumbre ◽  
Douglas N. Mintz ◽  
Sofia Hidalgo Perea ◽  
Joseph T. Nguyen ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Signal Intensity ◽  
Cruciate Ligament ◽  
Quadriceps Tendon ◽  
Hamstring Tendon ◽  
Skeletally Immature ◽  
Hamstring Tendon Autograft ◽  
Significant Difference ◽  
Anterior Cruciate ◽  
Tendon Autograft

Background: Hamstring tendon autograft (HTA) is a common graft choice for anterior cruciate ligament (ACL) reconstruction (ACLR) in skeletally immature patients. Recently, the use of quadriceps tendon autograft (QTA) has shown superior preliminary outcomes in this population. Purpose: To evaluate graft maturity by comparing magnetic resonance imaging (MRI) signal intensity of HTA versus QTA used in primary ACLR. Study Design: Cohort study; Level of evidence, 3. Methods: All patients under the age of 18 years who underwent a primary ACLR by the senior authors using either an HTA or a QTA were retrospectively reviewed. A total of 70 skeletally immature patients (37 in the HTA group and 33 in the QTA group) with an available MRI at 6 and 12 months postoperatively were included. Signal intensity ratio (SIR) was measured on sagittal MRI by averaging the signal at 3 regions of interest along the ACL graft and dividing by the signal of the tibial footprint of the posterior cruciate ligament. Statistical analysis was performed to determine interrater reliability and differences between time points and groups. Results: Age, sex, and type of surgery were not associated with any differences in SIR. There was no significant difference in SIR between groups on the 6-month MRI. However, the SIR of the QTA group was significantly less than in the HTA group on the 12-month MRI (2.33 vs 2.72, respectively; P = .028). Within the HTA group, there was no significant difference in SIR at either MRI time point. In the QTA group, there was a significant decrease in SIR between the 6-month and 12-month postoperative MRI (2.70 vs 2.33, respectively; P = .045). Conclusion: These findings suggest improved graft maturation, remodeling, and structural integrity of the QTA compared with the HTA between 6 and 12 months postoperatively. This provides evidence that, at 1 year postoperatively, QTA may have a superior rate of incorporation and synovialization as compared with the HTA.

Quadriceps Tendon Versus Hamstring Tendon Autografts for Anterior Cruciate Ligament Reconstruction: A Systematic Review and Meta-analysis

2021 ◽  
pp. 036354652110339
Author(s):  
Tze Khiang Tan ◽  
Arjun Gopal Subramaniam ◽  
Jay R. Ebert ◽  
Ross Radic
Keyword(s):  
Functional Outcomes ◽  
Observational Studies ◽  
Graft Failure ◽  
Cruciate Ligament ◽  
Meta Analysis ◽  
Knee Extensor ◽  
Quadriceps Tendon ◽  
Hamstring Tendon ◽  
Knee Extensor Strength ◽  
Anterior Cruciate

Background: Autograft choice in anterior cruciate ligament reconstruction (ACLR) remains controversial, with increasing interest in the usage of quadriceps tendon (QT) autograft versus traditional hamstring tendon (HT) use. The current study undertakes an in-depth review and comparison of the clinical and functional outcomes of QT and HT autografts in ACLR. Hypothesis: The QT autograft is equivalent to the HT autograft and there will be little or no significant difference in the outcomes between these 2 autografts. Study Design: Systematic review and meta-analysis; Level of evidence, 4. Methods: The PUBMED, EMBASE, MEDLINE, and CENTRAL databases were systematically searched from their inception until November 2020. All observational studies comparing ACLR QT and HT autografts were assessed for their methodological quality. Patient outcomes were compared according to patient-reported outcome measures (International Knee Documentation Committee [IKDC], Cincinnati, Lysholm, Tegner, and visual analog scale [VAS] measures), knee extensor and flexor torque limb symmetry indices (LSIs), hamstring to quadriceps (H/Q) ratios, functional hop capacity, knee laxity, ipsilateral graft failure, and contralateral injury. Results: A total of 20 observational studies comprising 28,621 patients (QT = 2550; HT = 26,071) were included in the quantitative meta-analysis. In comparison with patients who received an HT autograft, those who received a QT autograft had similar postoperative Lysholm (mean difference [MD], 0.67; P = .630), IKDC (MD, 0.48; P = .480), VAS pain (MD, 0.04; P = .710), and Cincinnati (MD, -0.85; P = .660) scores; LSI for knee flexor strength (MD, 6.06; P = .120); H/Q ratio (MD, 3.22; P = .160); hop test LSI (MD, -1.62; P = .230); pivot-shift test grade 0 (odds ratio [OR], 0.80; P = .180); Lachman test grade 0 (OR, 2.38; P = .320), side-to-side laxity (MD, 0.09; P = .650); incidence of graft failure (OR, 1.07; P = .830) or contralateral knee injury (OR, 1.22; P = .610); and Tegner scores (MD, 0.11; P = .060). HT autografts were associated with a higher (better) side-to-side LSI for knee extensor strength (MD, -6.31; P = .0002). Conclusion: In this meta-analysis, the use of the QT autograft was equivalent to the HT autograft in ACLR, with comparable graft failure and clinical and functional outcomes observed. However, HT autografts were associated with better LSI knee extensor strength.

Sign in / Sign up

Export Citation Format

Share Document