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OBJECTIVES: To compare clinical and functional outcomes of patients after primary anterior cruciate ligament reconstruction (ACLR) using quadriceps tendon- (QT-A) and hamstring tendon (HT-A) autograft with a minimum follow-up (FU) of 5 years. METHODS: Between 2010 and 2014, all patients undergoing ACLR were recorded in a prospectively administered database. All patients with primary, isolated QT-A ACLR and without any concomitant injuries or high grade of osteoarthritis were extracted from the database and matched to patients treated with HT-A. Re-rupture rates, anterior-posterior (ap) knee laxity, single-leg hop test (SLHT) performance, distal thigh circumference (DTC) and patient-reported outcome measures (PROMs) were recorded. Between group comparisons were performed using chi-square-, independent-samples T- or Mann-Whitney-U tests. RESULTS: , p = .27). No statistical between-group differences were found in ap knee laxity side-to-side (SSD) measurements (QT-A: 1.9 ± 1.2 mm, HT-A: 2.1 ± 1.5 mm; p = .60), subjective IKDC- (QT-A: 93.8 ± 6.8, HT-A: 91.2 ± 7.8, p = .17), Lysholm- (QT-A 91.9 ± 7.2, HT-A: 91.5 ± 9.7, p = .75) or any of the five subscales of the KOOS score (all p > .05). Furthermore, Tegner activity level (QT-A: 6(1.5), HT-A: 6(2), p = .62), VAS for pain (QT-A: 0.5 ± 0.9, HT-A: 0.6 ± 1.0, p = .64), Shelbourne-Trumper score (QT-A: 96.5 ± 5.6, HT-A: 95.2 ± 8.2, p = .50), Patient and Observer Scar -Assessment scale (POSAS) (QT-A: 9.4 ± 3.2, HT-A: 10.7 ± 4.9, p = .24), SSD-DTC (QT-A: 0.5 ± 0.5, HT.- A: 0.5 ± 0.6, p = .97), return to sports rates (QT-A: 82.1%, HT-A: 86.7%) and SLHT (QT -A: 95.9 ± 3.8%, HT-A: 93.7 ± 7.0%) did not differ between groups. Donor-site morbidity (HT-A n = 14, 46.7%; QT-A n = 3, 11.5%; p = .008) was statistically significantly lower in the QT-A group. Five patients (11.1%) of the HT-group and three patients (6.7%) in the QT-group required revision surgery (p = .29). CONCLUSION: Patient-reported outcome measures, knee laxity, functional testing results and re-rupture rates are similar between patients treated with QT- and HT- autografts. However, patients with QT-autograft have a smaller tibial postoperative scar length and lower postoperative donor-site morbidity. There is a tendency towards higher graft rupture rates in highly active patients treated with HT autograft. LEVEL OF EVIDENCE: II.
Runer et al. (Sat,) studied this question.