PMID- 36449046
OWN - NLM
STAT- MEDLINE
DCOM- 20230619
LR  - 20230619
IS  - 1433-7347 (Electronic)
IS  - 0942-2056 (Linking)
VI  - 31
IP  - 7
DP  - 2023 Jul
TI  - Anterior cruciate ligament reconstruction with all-soft tissue quadriceps tendon 
      versus quadriceps tendon with bone block.
PG  - 2844-2851
LID - 10.1007/s00167-022-07254-2 [doi]
AB  - PURPOSE: The purpose of this study was to evaluate whether there was a difference 
      in clinical outcomes between patients who underwent primary ACL reconstruction 
      (ACLR) with all-soft tissue quadriceps tendon (sQT) autograft versus QT with bone 
      block (bQT). METHODS: A retrospective cohort study of 708 patients who underwent 
      QT ACLR was conducted. Primary ACLR patients with at least 1 year of follow-up 
      were identified and those who received sQT were compared to those who received 
      bQT. Data collection entailed patient demographics, surgical variables, patient 
      reported outcomes (PROs), knee stability testing, and complications. The primary 
      outcome of interest was International Knee Documentation Committee (IKDC) score, 
      reported as mean score, pre- and postoperative difference, and number who met 
      minimum clinically important difference (MCID). Secondary outcomes included 
      Lachman and pivot shift grade, other patient reported outcomes (PROs), 
      complication rates, and return to sport (RTS). RESULTS: A total of 195 patients 
      (147 sQT, 48 bQT) who underwent primary QT ACLR met criteria for analysis, with 
      mean follow-up of 17.0 +/- 7.9 months. No difference was detected between cohorts 
      with respect to postoperative IKDC score (sQT: n = 120, 81.0 +/- 18.9, bQT: n = 10, 
      80.9 +/- 20.4, n.s.), proportion of patients who met MCID (sQT: 68/78 [87%], bQT: 
      6/7 [86%], n.s.), or results of stability testing. In the sQT cohort, 86% 
      (106/123) of athletes achieved full RTS, compared to 85% (34/40) in the bQT 
      cohort (n.s.). Time to RTS was less than a year in both cohorts (sQT: 
      10.5 +/- 3.8 months [n = 106], bQT: 11.1 +/- 3.9 months [n = 31], n.s.). Graft 
      rupture occurred in 7 (5%) sQT patients and 3 (6%) bQT patients (n.s.), and all 
      clinical failures were due to graft rupture (n.s.). No differences were detected 
      for rates of postoperative complications. CONCLUSION: No differences in clinical 
      outcomes were detected between patients who underwent primary ACLR with sQT 
      autograft versus bQT autograft. Currently, the decision to employ sQT or bQT is 
      largely determined by surgeon preference. This study demonstrates excellent 
      outcomes with both preparations and supports the use of either graft type at the 
      discretion of the treating surgeon. LEVEL OF EVIDENCE: III.
CI  - (c) 2022. The Author(s) under exclusive licence to European Society of Sports 
      Traumatology, Knee Surgery, Arthroscopy (ESSKA).
FAU - Setliff, Joshua C
AU  - Setliff JC
AUID- ORCID: 0000-0002-6674-1579
AD  - University of Pittsburgh School of Medicine, 3200 S Water Street, 
      PittsburghPittsburgh, PA, 15203, USA. setliffjc@upmc.edu.
FAU - Nazzal, Ehab M
AU  - Nazzal EM
AD  - Department of Orthopaedic Surgery, University of Pittsburgh Medical Center, 
      Pittsburgh, PA, USA.
FAU - Drain, Nicholas P
AU  - Drain NP
AD  - Department of Orthopaedic Surgery, University of Pittsburgh Medical Center, 
      Pittsburgh, PA, USA.
FAU - Herman, Zachary J
AU  - Herman ZJ
AD  - Department of Orthopaedic Surgery, University of Pittsburgh Medical Center, 
      Pittsburgh, PA, USA.
FAU - Mirvish, Asher B
AU  - Mirvish AB
AD  - University of Pittsburgh School of Medicine, 3200 S Water Street, 
      PittsburghPittsburgh, PA, 15203, USA.
FAU - Smith, Clair
AU  - Smith C
AD  - Department of Orthopaedic Surgery, University of Pittsburgh Medical Center, 
      Pittsburgh, PA, USA.
FAU - Lesniak, Bryson P
AU  - Lesniak BP
AD  - Department of Orthopaedic Surgery, University of Pittsburgh Medical Center, 
      Pittsburgh, PA, USA.
FAU - Musahl, Volker
AU  - Musahl V
AD  - Department of Orthopaedic Surgery, University of Pittsburgh Medical Center, 
      Pittsburgh, PA, USA.
FAU - Hughes, Jonathan D
AU  - Hughes JD
AD  - Department of Orthopaedic Surgery, University of Pittsburgh Medical Center, 
      Pittsburgh, PA, USA.
AD  - Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy, 
      University of Gothenburg, Gothenburg, Sweden.
LA  - eng
PT  - Journal Article
DEP - 20221130
PL  - Germany
TA  - Knee Surg Sports Traumatol Arthrosc
JT  - Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA
JID - 9314730
SB  - IM
MH  - Humans
MH  - Retrospective Studies
MH  - *Anterior Cruciate Ligament Injuries/complications/surgery
MH  - Tendons/transplantation
MH  - Knee Joint/surgery
MH  - *Anterior Cruciate Ligament Reconstruction/methods
MH  - Transplantation, Autologous
MH  - Autografts/surgery
MH  - *Hamstring Tendons/transplantation
OTO - NOTNLM
OT  - ACL reconstruction
OT  - Anterior cruciate ligament
OT  - Knee
OT  - Quadriceps tendon autograft
OT  - Sports medicine
EDAT- 2022/12/01 06:00
MHDA- 2023/06/19 13:08
CRDT- 2022/11/30 11:13
PHST- 2022/09/07 00:00 [received]
PHST- 2022/11/21 00:00 [accepted]
PHST- 2023/06/19 13:08 [medline]
PHST- 2022/12/01 06:00 [pubmed]
PHST- 2022/11/30 11:13 [entrez]
AID - 10.1007/s00167-022-07254-2 [pii]
AID - 10.1007/s00167-022-07254-2 [doi]
PST - ppublish
SO  - Knee Surg Sports Traumatol Arthrosc. 2023 Jul;31(7):2844-2851. doi: 
      10.1007/s00167-022-07254-2. Epub 2022 Nov 30.