Quadriceps tendon autograft has similar clinical outcomes when compared to hamstring tendon and bone-patellar tendon-bone autografts for revision ACL reconstruction: a systematic review and meta-analysis.
| Title: | Quadriceps tendon autograft has similar clinical outcomes when compared to hamstring tendon and bone-patellar tendon-bone autografts for revision ACL reconstruction: a systematic review and meta-analysis. |
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| Authors: | Ashy C; Department of Orthopaedics and Physical Medicine, Clinical Sciences Building, CSB, Medical University of South Carolina, 96 Jonathan Lucas Street, MSC Code: 708, Charleston, SC, 29425, USA. ashy@musc.edu.; Bailey E; College of Medicine, Medical University of South Carolina, Charleston, USA.; Hutchinson J; College of Medicine, Medical University of South Carolina, Charleston, USA.; Brennan E; MUSC Libraries, Medical University of South Carolina, Charleston, USA.; Bailey R; Independent Statistician, Charleston, USA.; Michael Pullen W; Department of Orthopaedics and Physical Medicine, Clinical Sciences Building, CSB, Medical University of South Carolina, 96 Jonathan Lucas Street, MSC Code: 708, Charleston, SC, 29425, USA.; Xerogeanes JW; Department of Orthopaedic Surgery, Emory University, Atlanta, USA.; Slone HS; Department of Orthopaedics and Physical Medicine, Clinical Sciences Building, CSB, Medical University of South Carolina, 96 Jonathan Lucas Street, MSC Code: 708, Charleston, SC, 29425, USA. |
| Source: | Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA [Knee Surg Sports Traumatol Arthrosc] 2023 Dec; Vol. 31 (12), pp. 5463-5476. Date of Electronic Publication: 2023 Oct 07. |
| Publication Type: | Meta-Analysis; Systematic Review; Journal Article |
| Language: | English |
| Journal Info: | Publisher: Wiley Country of Publication: Germany NLM ID: 9314730 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1433-7347 (Electronic) Linking ISSN: 09422056 NLM ISO Abbreviation: Knee Surg Sports Traumatol Arthrosc Subsets: MEDLINE |
| Imprint Name(s): | Publication: 2024- : [Hoboken] : Wiley; Original Publication: [Heidelberg, Germany] : Springer International, c1993- |
| MeSH Terms: | Hamstring Tendons*/transplantation ; Patellar Ligament*/surgery ; Anterior Cruciate Ligament Injuries*/surgery; Autografts/surgery ; Tendons/transplantation ; Humans ; Transplantation, Autologous ; Bone-Patellar Tendon-Bone Grafting |
| Abstract: | Purpose: Research regarding revision anterior cruciate ligament reconstruction (RACLR) with quadriceps tendon (QT) autografts is lacking. The purpose of this study was to perform a systematic review and meta-analysis of RACLR with QT and compare its patient outcomes to RACLR with hamstring tendon (HT) and bone-patellar tendon-bone (BTB) autografts.; Methods: Adhering to PRISMA guidelines, a search for studies using QT in RACLR was performed within PubMed, Scopus, and CINAHL from database date of inception through December 26, 2022. Primary outcomes sought included: failure rate, Lysholm scores, International Knee Documentation Committee (IKDC) scores, IKDC grades, arthrometric knee side-to-side differences (STSD), pivot shift grade, donor site morbidity, return to sport, visual analog scale (VAS) pain scores.; Results: Nine studies were included consisting of 606 RACLR: 349 QT, 169 HT, and 88 BTB. Overall failure rates were 7.6% QT, 13.3% HT, and 8.7% BTB. Mean weighted Lysholm scores were 85.8 ± 3.8 QT, 82.5 ± 3.8 HT and 86.6 ± 4.5 BTB. IKDC average scores were 82.3 ± 1.6 QT, 80.1 ± 1.7 HT, and 81.7 ± 5.5BTB. Combined rates of IKDC A/B grades were 88.4% and 80.0% for QT and HT, respectively. VAS average scores were 0.9 ± 1.1 QT, 1.4 ± 0.2 HT, and 0.7 ± 0.8 for BTB. Side-to-side difference was reported for QT and HT with average values of 1.7 ± 0.6 mm and 2.1 ± 0.5 mm, respectively. Grade 0 or 1 pivot shifts were reported in 96.2% of QT patients and 91.3% of HT. Donor site morbidity, only reported for QT and HT, was 14.6 ± 9.7% and 23.6 ± 14.1%, respectively. QT resulted in a mean Tegner score of 5.9 ± 1.5 versus HT 5.7 ± 1.5. Rate of return to pivoting sports was 38.0% QT, 48.6% HT, and 76.9% BTB. Across all outcomes, there was no significant difference when comparing QT to HT, QT to BTB, and QT compared to HT and BTB combined.; Conclusions: RACLR with QT yields satisfactory patient reported outcomes, satisfactory improvement in knee laxity, expected return to sport rates, and has an overall 7.6% failure rate. Outcomes are comparative to those of HT and BTB making it an acceptable graft choice for RACLR. Surgeons should consider using QT autograft for RACLR, especially when other autografts are unavailable.; Level of Evidence: IV.; (© 2023. The Author(s) under exclusive licence to European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA).) |
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| Contributed Indexing: | Keywords: ACL; Bone–patellar tendon–bone; General; Hamstring tendon; Knee; Quadriceps tendon; Revision anterior cruciate ligament reconstruction |
| Entry Date(s): | Date Created: 20231007 Date Completed: 20231216 Latest Revision: 20231216 |
| Update Code: | 20260130 |
| DOI: | 10.1007/s00167-023-07592-9 |
| PMID: | 37804345 |
| Database: | MEDLINE |
Meta-Analysis; Systematic Review; Journal Article