Quadriceps autograft in ACL reconstruction may decrease failure, accelerate return to play
Key takeaways:
- Results showed that quadriceps autograft decreased failure rates and accelerated return to play compared with hamstring autograft alone.
- Further research may be necessary in a larger study population.
WASHINGTON — Results presented here showed quadriceps autograft may decrease clinical failure rates and accelerate return to play compared with hamstring autograft alone after ACL reconstruction.
“We found that the all-tissue quad autograft was equivalent to the hamstring autograft and [lateral extra-articular tenodesis] LET in high-risk patients. We also found that the quad autograft was able to reduce residual pivot shift similar to that of the LET with a hamstring autograft,” Kostas Economopoulos, MD, said in his presentation at the American Orthopaedic Society for Sports Medicine Annual Meeting. “LET addition did not lead to a lower return rate, and the quad autograft was able to return the athletes back to sport in a shorter time period.”
Economopoulos and colleagues categorized 166 high-risk patients with either at least grade 2 pivot shift or general ligamentous laxity undergoing ACL reconstruction into groups based on whether they received a quadriceps autograft, hamstring autograft with LET or hamstring autograft alone.
“We looked at the outcomes of clinical failure, which included residual pivot shift or graft tear, along with return to sport and complications,” Economopoulos said.
Economopoulos said quadriceps autografts had an association with decreased clinical failure rates compared with hamstring autograft alone and had similar rates compared with the hamstring with LET group. He added the quadriceps autograft group and the hamstring autograft with LET group had a decreased graft retear rate, with minimal differences between the two groups, compared with the hamstring autograft alone group. Although the quadriceps autograft group and hamstring autograft with LET group reduced the residual pivot shift with minimal differences, Economopoulos said the quadriceps autograft group trended toward a higher pivot shift rate. However, this did not reach statistical significance, according to Economopoulos.
“Looking at return to sport, the three graft choices seemed to return people to sport at similar rates and at the same or higher levels,” Economopoulos said. “But we did find that the addition of a quad autograft did lead to a faster return to play at 7.5 months compared to about 9.5 months with the hamstring autograft group.”
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Economopoulos K, et al. Paper 28. Presented at: American Orthopaedic Society for Sports Medicine Annual Meeting; July 12-16, 2023; Washington, D.C.
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