Anterior Cruciate Ligament Reconstruction Using Quadriceps Tendon Autograft: Intermediate-Term Outcome

Geib, Timothy M.; Shelton, Walter R.; Phelps, Raymond A.; Clark, Lauren

doi:10.1016/j.arthro.2009.06.004

Cited by 157 publications

(181 citation statements)

References 27 publications

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“…Kim et al [17] reported that the postoperative mean side-to-side difference for single bundle quadriceps reconstruction in 28 patients was 2.64 mm. According to Geib et al, [9] when compared with BPTB autograft, the quadriceps tendon autograft showed significantly higher percentage of arthrometer measurements showing a side-to-side difference less than 3 mm in 88% of the patients. Another study showed that following ACL reconstruction with a central quadriceps tendon autograft, 68% of 240 patients had less than 3 mm anteroposterior laxity.…”

Section: Discussionmentioning

confidence: 99%

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Artroskopik ön çapraz bağ onarımı için hamstring tendon otogreftine kıyasla kuadriseps tendon kullanımı: Klinik sonuçların karşılaştırmalı analizi

Sofu

Şahin

Gürsü

et al. 2013

Eklem Hastalik Cerrahisi

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Knee ligament injuries are among the most frequently encountered injuries. [1,2] Although different types of surgical techniques with excellent clinical results have been reported for the reconstruction of a ruptured anterior cruciate ligament (ACL), graft selection is still a controversial issue. Every particular graft type Amaç: Bu çalışmada, iki otojen greft türünün kullanımına ilişkin orta dönem klinik sonuçlar değerlendirildi. Hastalar ve yöntemler: Haziran 2005 -Kasım 2010 tarihleri arasında ameliyat edilen 44 hastanın klinik verileri retrospektif olarak incelendi. Onarım cerrahisi için 23 hastada (QT-PB grubu) kuadriseps tendon-patella kemiği otogrefti, 21 hastada (HT grubu) ise dört katlı hamstring tendon otogrefti kullanıldı. Veri toplamada Tegner aktivite skalası, Lysholm skorlama sistemi, tek bacak sıçrama testi ve KT-2000 artrometrik ölçümleri kullanıldı. Bulgular: Ortalama takip süresi 37.6 aydı. Ortalama Lysholm skoru her iki grupta da artmasına rağmen, HT grubunda elde edilen mükemmel sonuçlar QT-PB grubundakinin iki katı kadardı. Ortalama laksite miktarı QT-PB grubunda 5.65 mm (3.5-8.0 mm) iken HT grubunda 3.67 mm (3.0-5.5 mm) olarak ölçüldü. KT-2000 artrometre kullanıla-rak yapılan bire bir analizde QT-PB grubunda 12 hastada (%52.1) ve HT grubunda iki hastada (%9.6) 3 mm'den fazla ön laksite farkı saptandı. Sonuç: Artroskopik ön çapraz bağ onarım cerrahisinde dört katlı hamstring tendon otogrefti, santral kuadriseps tendonpatella kemiği otogreftinden üstündür.Anahtar sözcükler: Ön çapraz bağ onarımı; ön çapraz bağ; artroskopi; kuadriseps kası; tendon.Objectives: This study aims to evaluate midterm clinical results of the use of two autogenous graft types. Patients and methods: Between June 2005 and November 2010, clinical data of 44 patients who were operated were retrospectively analyzed. Quadriceps tendon-patellar bone autograft was used for reconstruction surgery in 23 patients (QT-PB group), while quadrupled hamstring tendon autograft was used in 21 patients (HT group). The Tegner's activity scale, Lysholm scoring system, single-leg-hop test and KT-2000 arthrometric measurements were used for data collection. Results: The mean length of follow-up was 37.6 months. Although the mean Lysholm score increased in both groups, excellent results in HT group were two-fold higher compared to QT-PB group. The mean laxity for the operated knee joint was 5.65 mm (3.5 to 8.0 mm) in QT-PB group and 3.67 mm (3.0 to 5.5 mm) in HT group. Head-to-head analysis using KT-2000 arthrometer demonstrated that 12 patients (52.1%) in QT-PB group and two patients (9.6%) in HT group had more than 3 mm of anterior laxity difference. Conclusion: Quadrupled hamstring tendon autograft is superior to central quadriceps tendon-patellar bone in arthroscopic anterior cruciate ligament reconstruction surgery.

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Section: Discussionmentioning

confidence: 99%

“…Geib et al [9] reported that donor site morbidity following quadriceps tendon autograft harvesting is less than that of patellar tendon graft. Anterior knee pain and kneeling pain have been shown to be lower in hamstring autograft patients.…”

Section: Discussionmentioning

confidence: 99%

Artroskopik ön çapraz bağ onarımı için hamstring tendon otogreftine kıyasla kuadriseps tendon kullanımı: Klinik sonuçların karşılaştırmalı analizi

Sofu

Şahin

Gürsü

et al. 2013

Eklem Hastalik Cerrahisi

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“…Anterior knee pain is a common problem after quadriceps and patellar tendon harvesting. When compared with patellar tendon, less anterior knee pain occurs with quadriceps tendon harvesting while the latter has not shown any patellar tendon shortening or infrapatellar contracture associated with patellar tendon autograft (10).…”

Section: Journal Of Turgut Ozal Medical Center Wwwjtomcorg Edi̇töre mentioning

confidence: 99%

Anatomic Anterior Cruciate Ligament Reconstruction by Using Quadriceps Tendon Autograft

2015

J Turgut Ozal Med Cent

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The anterior cruciate ligament (ACL) injuries are common knee injuries especially in people younger than 30 years of age and those who are physically active. These injuries are mostly seen with high incidence rates in adolescents playing pivoting sport activities such as football and basketball. Because of their larger pelvic diameters, young women have a 35 times higher risk of ACL injury than men in pivoting sports (1-3). The goals of ACL reconstruction are to regain stability and unrestricted function as well as to protect joint health in the long term. Current treatments for ACL injury are moderately successful and most individuals are able to return to their preinjury level of sports activity (4, 5). But after beginning recreational activities, ACL rerupture is the most common problem and, for this reason, it requires further analysis so as to decide the best option for ACL reconstruction injury methods and appropriate graft choices.A 25 years-old man with knee instability was referred to our orthopaedic clinic. He was a football player and had an injury history about one month ago with forced rotation in his right knee. In physical examination, he had moderate pain and suprapatellar effusion. His McMurray, varus-valgus, and posterior drawer tests were negative. But he had positive anterior drawer and lachmann tests. The Lysholm knee score was 64 while his Cincinati score was 52. The Tegner score was 3,6. Magnetic resonance imaging (MRI) showed ACL rupture in the right knee with no accompanying injuries. We performed an arthroscopical anatomic single bundle ACL reconstruction by using the autogen quadriceps tendon. No accompanying injuries were detected during arthroscopic surgery. After the surgery, we used a knee brace with an angle-adjustable hinge for 4 weeks. Within 2-14 postoperative days, we obtained full extension, minimized swelling, active quadriceps control, and 90 degrees of flexion. Within 2-6 weeks, we increased flexion to 135 degrees. We obtained full range of motion within 6-9 weeks in addition to increased functional activities, improved muscle strength, and endurance within 9-12 weeks. After 12 weeks, we asked the patient to start light sport activities. 6 months after the surgery, the patient resumed pivoting activities. At the end of 6 months, the Lysholm knee score was 86, Cincinati score was 78, and Tegner score was 5.8. The graft was intact on MRI and the femoral tunnel enlargement was 0.68 mm.

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“…Geib et al [25] and Han et al [30] found the incidence of anterior knee pain to be significantly lower with a quadriceps tendon autograft than with a BPTB. On the contrary, Lee et al [24] reported that an incidence of anterior knee pain was similar for quadriceps tendons and hamstring tendon autografts.…”

Section: Anterior Knee Painmentioning

confidence: 99%

“…Additionally, Geib et al [25] compared the intermediate term outcome results of an ACL reconstruction through the use of a BPTB and quadriceps tendon (QT) with and without a bone block. When compared to BPTB autograft, the quadriceps tendon autograft showed significantly better results, including: less anterior knee pain, less anterior numbness, a higher percentage of arthrometer measurements showing a side-to-side difference of 0-3 mm and better extension.…”

Section: Functional Outcomesmentioning

confidence: 99%

Anterior Cruciate Ligament Reconstruction: Which Graft to Use?

Sedeek

2013

J Curr Surg

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The anterior cruciate ligament is the most commonly injured ligament within the knee and its injury mostly occurs among young and active individuals. In the last few decades, the proper kind of graft choice that should be used for cruciate ligament reconstruction has been controversial. In addition to bone-patellar and tendon-bone autografts, many other choices have become popular, such as using hamstring tendons and allografts. The aim of this article is to evaluate the kinds of choices that are available for grafting and to assess their advantages, disadvantages, clinical outcome, donor site morbidity, and biomechanical criteria and healing factors. In conclusion, there are certain situations where one graft may be favored over another. However, a universally accepted ideal graft choice currently does not exist. Therefore, a good surgeon should be familiar with the different types of grafting choices.

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Anterior Cruciate Ligament Reconstruction Using Quadriceps Tendon Autograft: Intermediate-Term Outcome

Cited by 157 publications

References 27 publications

Artroskopik ön çapraz bağ onarımı için hamstring tendon otogreftine kıyasla kuadriseps tendon kullanımı: Klinik sonuçların karşılaştırmalı analizi

Artroskopik ön çapraz bağ onarımı için hamstring tendon otogreftine kıyasla kuadriseps tendon kullanımı: Klinik sonuçların karşılaştırmalı analizi

Anatomic Anterior Cruciate Ligament Reconstruction by Using Quadriceps Tendon Autograft

Anterior Cruciate Ligament Reconstruction: Which Graft to Use?

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