Anterior Cruciate Ligament Reconstruction Using Quadriceps Tendon Autograft in Adolescent Athletes

Vaughn, Natalie H.; Jackson, Trevor; Hennrikus, William L.

doi:10.1542/peds.141.1_meetingabstract.194

Cited by 2 publications

(11 citation statements)

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“…Four studies (147 patients) reported Lysholm scores postoperatively at final reported follow‐up, with mean scores ranging from 94.0 to 99.5 (Fig. 2) [19, 33, 54, 75]. Three studies (151 patients) reported data on postoperative IKDC subjective scores at final reported follow‐up, with mean scores ranging from 75.9 to 94.0 (Fig.…”

Section: Resultsmentioning

confidence: 99%

“…Two studies (105 patients) reported rates of RTS, with mean rates ranging from 72/81 patients (88.9%) (95% CI 82.7–95.5%) at 36 months postoperation to 22/24 patients (91.7%) at 24 months postoperation [19, 75]. It should be noted that the lowest rate of RTS (88.9%) specified requirements of > 90% LSI on single‐leg functional tests or clinician approval [19], whereas the highest rate of RTS (91.7%) did not specify the criteria used to permit RTS [75].…”

Section: Resultsmentioning

confidence: 99%

“…The initial literature search yielded 1216 unique studies, of which six met the inclusion and exclusion criteria for this systematic review [19, 26, 33, 43, 47, 54]. Furthermore, eight conference abstracts were included [1, 7, 39, 51, 53, 66, 71, 75]. No additional studies were included upon repeating the search strategy, nor through manually searching references of included studies and pertinent review papers (Fig.…”

Section: Resultsmentioning

confidence: 99%

“…Notably, QT autograft ACLR yields favorable RTS rates among this active, high‐risk patient population. A total of 94/105 patients (89.5%) returned to preinjury level of play [19, 75]. Compared to alternative grafts, a systematic review (20 studies) exclusively assessing RTS after BPTB, HT, or allograft ACLR in the pediatric population found 78.6% (95% CI 70.7–85.7%) of patients returned to preinjury sporting level, while up to 91% (95% CI 84–96%) of patients undergoing HT ACLR returned to any level of sport participation [31].…”

Section: Discussionmentioning

confidence: 99%

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Quadriceps tendon autograft for pediatric anterior cruciate ligament reconstruction results in promising postoperative function and rates of return to sports: A systematic review

Zakharia

Lameire

Khalik

et al. 2022

Knee Surg Sports Traumatol Arthrosc

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PurposeTo assess the performance of the quadriceps tendon (QT) autograft in pediatric anterior cruciate ligament reconstruction (ACLR). MethodsA systematic search of MEDLINE, PubMed, and EMBASE was conducted on March 1, 2021. Studies of all levels of evidence reporting outcomes and/or complications after QT autograft ACLR in pediatric patients (≤ 18 years old) were eligible for inclusion. Study demographics, patient demographics, reported outcomes, and complications were abstracted. Screening and data abstraction were designed in accordance with PRISMA and R‐AMSTAR guidelines. Descriptive statistics were presented when applicable, with data for heterogeneous outcomes presented in narrative summary fashion. ResultsA total of 14 studies examining 596 patients (46.3% female), mean age 15.4 years, were included in this systematic review. Mean postoperative Lysholm scores ranged from 94.0 to 99.5. Mean postoperative IKDC subjective scores ranged from 75.9 to 94.0. Limb symmetry index ranged from 96.8 ± 10.4 to 100.4 ± 7.6% across multiple hop tests. Return to sports (RTS) rates ranged from 88.9 to 91.7%. Eleven studies reported postoperative complications, whereby 16 patients (4.8%) experienced contralateral complications and injuries. Forty‐six patients (9.4%) experienced ipsilateral complications, including ten graft failures (2.5%) and two growth disturbances (0.6%). ConclusionsQT autograft ACLR in the pediatric population retains the potential of regaining a preinjury level of knee stability, and yields promising postoperative function and rates of RTS, yielding comparable outcomes relative to HT autograft and the reference‐standard BPTB ACLR that have previously been described in the literature. Moreover, use of the QT autograft is associated with low rates of postoperative complications, including graft failure and growth disturbances in this active and high‐risk patient population in observational studies to date. Therefore, clinical equipoise exists to further appraise the influence of QT autograft on postoperative outcomes compared to aforementioned autograft options in a randomized control trial fashion. Level of evidenceIV.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Quadriceps tendon autograft for pediatric anterior cruciate ligament reconstruction results in promising postoperative function and rates of return to sports: A systematic review

Zakharia

Lameire

Khalik

et al. 2022

Knee Surg Sports Traumatol Arthrosc

View full text Add to dashboard Cite

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“…However, there are potential drawbacks and complications associated with using the anterior approach to harvest hamstring tendon autograft [2,12,16,19]. These include difficulty identifying the tendons, iatrogenic saphenous nerve injury, graft site morbidity, anterior scar cosmesis, and premature amputation of the tendon during harvest [3,7,14,15,18,21].…”

Section: Introductionmentioning

confidence: 99%

Posterior Approach With Small Incision Is a Safe Alternative to Anterior Approach for Hamstring Autograft Harvest in Adolescents

Aitchison

Schlichte

Heath

et al. 2022

HSS Journal®: The Musculoskeletal Journal of Hospital for Speci

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Background: There are potential drawbacks and complications associated with using the anterior approach to harvest the hamstring tendon as an autograft source for anterior cruciate ligament (ACL) and medial patellofemoral ligament (MPFL) reconstruction. A posterior harvest technique has been described as an alternative to an anterior approach in skeletally mature patients. The 2 approaches have not been compared in adolescents. Purpose: We sought to compare the incision size and harvested tendon length produced by anterior and posterior hamstring harvest techniques in an adolescent population. Methods: After obtaining consent, we prospectively collected data on a consecutive series of 115 adolescents undergoing ACL or MPFL reconstruction, including the length of the incision and of the harvested hamstring tendon. Demographic information including age, sex, and body mass index (BMI) was collected at the time of surgery. Results: The mean age at the time of surgery was 14.3 ± 1.8 years (range: 9–21 years), and 43% (N = 50) of participants were male. Of the 115 hamstring autografts, 26 were harvested anteriorly and 89 were harvested posteriorly. Neither mean semitendinosus length nor mean gracilis length was significantly different when harvested anteriorly versus posteriorly. The posterior harvest group had a mean incision length that was significantly smaller than that of the anterior harvest group. No iatrogenic nerve injuries or neurovascular complications were observed in either group. Conclusion: A posterior incision for hamstring autograft harvest provided an alternative approach in adolescents, which resulted in a 20% smaller incision than an anterior approach. For procedures such as MPFL reconstruction that do not require concomitant anteromedial work, posterior hamstring harvest may be used to improve cosmesis while producing viable hamstring autograft tissue for surgical reconstruction.

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Anterior Cruciate Ligament Reconstruction Using Quadriceps Tendon Autograft in Adolescent Athletes

Cited by 2 publications

References 0 publications

Quadriceps tendon autograft for pediatric anterior cruciate ligament reconstruction results in promising postoperative function and rates of return to sports: A systematic review

Quadriceps tendon autograft for pediatric anterior cruciate ligament reconstruction results in promising postoperative function and rates of return to sports: A systematic review

Posterior Approach With Small Incision Is a Safe Alternative to Anterior Approach for Hamstring Autograft Harvest in Adolescents

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