Quadriceps Tendon Autograft in Anterior Cruciate Ligament Reconstruction: A Systematic Review

Purpose To systematically review the current evidence to ascertain whether quadriceps tendon autograft (QT) is a viable option in anterior cruciate ligament reconstruction. Methods A literature review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta‐analyses (PRISMA) guidelines. Cohort studies comparing QT with bone–patellar tendon–bone autograft (BPTB) or hamstring tendon autograft (HT) were included. Clinical outcomes were compared, with all statistical analyses performed using IBM SPSS Statistics for Windows, version 22.0, with P < .05 being considered statistically significant. Results We identified 15 clinical trials with 1,910 patients. In all included studies, QT resulted in lower rates of anterior knee pain than BPTB. There was no difference in the rate of graft rupture between QT and BPTB or HT in any of the studies reporting this. One study found that QT resulted in greater knee stability than BPTB, and another study found increased stability compared with HT. One study found that QT resulted in improved functional outcomes compared with BPTB, and another found improved outcomes compared with HT, but one study found worse outcomes compared with BPTB. Conclusions Current literature suggests QT is a viable option in anterior cruciate ligament reconstruction, with published literature showing comparable knee stability, functional outcomes, donor‐site morbidity, and rerupture rates compared with BPTB and HT. Level of Evidence Level III, systematic review of Level I, II, and III studies.