Quadriceps tendon autograft for arthroscopic knee ligament reconstruction: use it now, use it often

2018 ◽  
Vol 52 (11) ◽  
pp. 698-701 ◽  
Author(s):  
Andrew J Sheean ◽  
Volker Musahl ◽  
Harris S Slone ◽  
John W Xerogeanes ◽  
Danko Milinkovic ◽  
...  

Traditional bone-patellar tendon-bone and hamstring tendon ACL grafts are not without limitations. A growing body of anatomic, biomechanical and clinical data has demonstrated the utility of quadriceps tendon autograft in arthroscopic knee ligament reconstruction. The quadriceps tendon autograft provides a robust volume of tissue that can be reliably harvested, mitigating the likelihood of variably sized grafts and obviating the necessity of allograft augmentation. Modern, minimally invasive harvest techniques offer the advantages of low rates of donor site morbidity and residual extensor mechanism strength deficits. New data suggest that quadriceps tendon autograft may possess superior biomechanical characteristics when compared with bone-patella tendon-bone (BPTB) autograft. However, there have been very few direct, prospective comparisons between the clinical outcomes associated with quadriceps tendon autograft and other autograft options (eg, hamstring tendon and bone-patellar tendon-bone). Nevertheless, quadriceps tendon autograft should be one of the primary options in any knee surgeon’s armamentarium.

Author(s):  
Gerwin Haybäck ◽  
Christoph Raas ◽  
Ralf Rosenberger

Abstract Introduction In this review paper, graft failure rates of different graft types (hamstring tendon autografts, bone–patellar tendon–bone autografts, quadriceps tendon autografts and diverse allografts) that are used for surgical reconstruction of the anterior cruciate ligament are compared and statistically analysed. Methods Literature search was conducted in PubMed according to Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) criteria. A total of 194 studies, which reported graft failure rates of at least one of the anterior cruciate ligament reconstruction methods mentioned above, were included in this systematic review. To be able to compare studies with different follow-up periods, a yearly graft failure rate for each reconstruction group was calculated and then investigated for significant differences by using the Kruskal–Wallis test. Results Overall, a total of 152,548 patients treated with an anterior cruciate ligament reconstruction were included in the calculations. Comparison of graft types showed that hamstring tendon autografts had a yearly graft failure rate of 1.70%, whereas the bone–patellar tendon–bone autograft group had 1.16%, the quadriceps tendon autograft group 0.72%, and the allografts 1.76%. Conclusion The findings of this meta-data study indicate that reconstructing the anterior cruciate ligament using quadriceps tendon autografts, hamstring tendon autografts, patellar tendon autografts or allografts does not show significant differences in terms of graft failure rates.


2020 ◽  
Vol 1 (1) ◽  
pp. 57-62
Author(s):  
Muhammad Hilman Bimadi ◽  
Krisna Yuarno Phatama ◽  
Edi Mustamsir

Introduction: The peroneus longus (PL) tendon is one of the autograft choices for knee ligament injury because of its safety, length, and strength. However, studies that evaluated donor site morbidity after PL tendon graft are still limited. This case series aims to evaluate the functional outcomes of donor site morbidity after full-thickness PL tendon harvesting for knee ligament reconstruction.Presentation of Case:This study evaluated four patients who had a revision of knee ligament reconstruction surgery using PL tendon autograft from August until September 2018. The functional outcome of the donor site was evaluated before surgery, two weeks, and three months after surgery by using functional scores assessment of foot and ankle.Discussion:There are some donor sites of autograft, but several studies show that the PL tendon autograft has proven to be more favorable methods for knee ligament reconstruction based on the accessibility, safety, and strength of the harvested tendon. The studies also found that using PL tendon as an autograft, has a good result in donor site morbidity evaluation compared to others. This study provides a satisfying result on the functional outcome of the donor site morbidity evaluation.Conclusion:This study showed satisfactory functional outcomes of the foot and ankle after harvesting full-thickness PL tendon. All functional score assessment provides an excellent result in three months after surgery, although lateral ankle bulging has occurred in all patients. However, gait analysis and isokinetic test with a more significant number of patients and longer follow up periods are necessary for further study.


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