Quadriceps grafts had similar revision, reoperation rates vs. patellar, hamstring grafts
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Key takeaways:
- Quadriceps tendon grafts had a revision rate of 2.7% vs. 3% for bone-patellar tendon-bone grafts.
- Quadriceps tendon grafts had a revision rate of 2.7% vs. 4.5% for hamstring tendon grafts.
NEW ORLEANS — Results presented here showed quadriceps tendon grafts had no significant differences in revision or reoperation rates after ACL reconstruction compared with bone-patellar tendon-bone or hamstring autografts.
Using the Kaiser Permanente ACL Reconstruction Registry, Gregory B. Maletis, MD, and colleagues longitudinally followed about 22,000 patients who underwent ACL reconstruction with a quadriceps tendon autograft, bone-patellar tendon-bone autograft or hamstring tendon autograft. Researchers used validated screening tools to validate all outcomes.
“We used Cox proportional hazard regression models that were adjusted for both patient and surgical factors, as well as the operating surgeon,” Maletis said in his presentation at the Arthroscopy Association of North America Annual Meeting. “We looked at hazard ratios and also the numbers needed to treat.”
Maletis noted patients who received a quadriceps tendon autograft had a 4-year incidence of revision of 2.7% vs. 3% for patients who had bone-patellar tendon-bone autografts. He added patients had a reoperation rate of 8.1% in the quadriceps tendon autograft group vs. 7.9% in the bone-patellar tendon-bone group. Neither of these results were statistically significant, according to Maletis.
“When we looked at quad tendons vs. hamstring tendons, we found an incidence of revision of 2.7% for quad tendons and 4.5% for hamstring tendons, and reoperation was 8.1% vs. 7%,” Maletis said. “These were also not statistically significant with these numbers.”
Maletis noted that for every 30 patients younger than 22 years of age who received a quadriceps tendon vs. a hamstring tendon, one revision might be saved.
Patients in the hamstring tendon autograft group had a revision rate of 4.5% and a reoperation rate of 7% compared with a 3% revision rate and 7.9% reoperation rate among patients in the bone-patellar tendon-bone autograft group, according to Maletis.
“This was statistically significantly different, with a revision rate of 1.5-times higher in the hamstring group,” Maletis said. “But, again, if we look at the numbers needed to treat in the younger patient population, for every 36 cases one would do with a patellar tendon as opposed to a hamstring tendon you could potentially save one revision.”
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Maletis GB, et al. Risk of reoperation after ACL reconstruction: Comparison of quad, BPTB and hamstring autografts in a U.S. cohort of 19,960. Presented at: Arthroscopy Association of North America Annual Meeting; May 4-6, 2023; New Orleans.
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