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Low morbidity, pain using quadriceps free tendon for ACL reconstruction
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WASHINGTON — Using a central quadriceps free tendon autograft may provide a reliable, pain-free, low-morbidity option for patients undergoing ACL reconstruction.
In a retrospective review of prospectively collected data, Joseph P. DeAngelis, MD, and colleagues studied the results of 168 patients who underwent ACL reconstruction using the central-third quadriceps tendon as a free autograft and had undergone surgery at least 2 years ago. The patients had an average follow-up of 5.8 years and an average International Knee Documentation Committee score of 87. The investigators discovered one infection that required a reoperation and five graft failures.
They also found no tenderness to palpation at the donor site, anterior knee pain or extension lag in any of the patients. All of the patients also showed a symmetric range of motion during both passive and active examinations.
The average single-leg hop score was 0.96, and 86% of patients demonstrated a side-to-side difference of less than 3 mm. KT-1000 testing at 20 pounds showed an average difference of 1.2 mm and 1.8 mm at manual maximum testing.
"From these results, we reached the conclusion that the free tendon central quadriceps graft can provide reliable and stable results at greater than 5 years," DeAngelis said during his presentation. "There is limited donor site morbidity, minimal anterior knee pain, and in this capacity we believe that this graft provides a pain-free, low-morbidity recovery for patients. Actually, it may be the least morbid of all currently used autograft tissues, and it additionally provides a reliable alternative for primary, revision and potentially double-bundle techniques."
The investigators invited patients who had undergone a unilateral ACL reconstruction using a central quadriceps free tendon to participate in the study. Of the 168 patients in the study, investigators obtained subjective data on 46% and objective data on 26%. They lost 71 patients (42%) to follow-up.
For more information:
- DeAngelis J, Cote M, Fulkerson JP, et al. Central quadriceps tendon for anterior cruciate ligament reconstruction: Long-term results. Paper #SS-33. Presented at the 27th Annual Meeting of the Arthroscopy Association of North America. April 24-27, 2008. Washington.