COLORADO SPRINGS, Colo. — Quadriceps tendon autograft can be as effective as bone-patellar tendon-bone autograft for primary ACL reconstruction in cutting and pivoting athletes, according to a presentation.
“In the short term, quad tendon soft tissue autografts seem to function just as well as BTB autografts for ACL reconstruction in cutting and pivoting athletes,” Kostas J. Economopoulos, MD, said at the American Orthopaedic Society for Sports Medicine Annual Meeting.
“We did find that quad tendon autografts in our small group of patients did return the athletes at a significantly shorter period of time than bone-patellar tendon-bone autografts. We feel that quad tendon autografts should be considered when discussing surgical options with athletes who participate in cutting and pivoting sports,” he continued.
Kostas J. Economopoulos
In a retrospective, single surgeon study, Economopoulos and colleagues identified high-level, high school and college athletes with ACL tears who played the cutting and pivoting sports of soccer, football, basketball and lacrosse. Overall, 32 athletes had received soft tissue quadriceps autograft and 36 patients had received bone-patellar tendon-bone autograft in primary ACL reconstructions. All patients had at least 2 years of follow-up and rehabilitation and return-to-play protocols were identical.
Researchers used IKDC and Lysholm scores to evaluate patient-reported outcomes. Meniscal surgery was performed in combination with the ACL reconstruction in 17 patients in the quadriceps group, and average graft size was 9.5 mm. Meniscal surgery was performed in 22 athletes of the bone-patellar tendon-bone autograft group, and average graft size was 10 mm.
Researchers found no difference in patient-reported outcomes, return-to-play or re-tear rates. At the 2-year follow-up, the IKDC score was 93.6 and Lysholm score was 95.7 for patients in the quadriceps group, and the IKDC score was 95.1 and Lysholm score was 96.1 for the bone-patellar tendon-bone group. For patients in the quadriceps group, return-to-play was 88%, return-to-play at the same level was 65.6% and the average time to return was 7.7 months. For patients in the bone-patellar tendon-bone group, return-to-play was 83%, return-to-play at the same level was 47.2% and the average time to return was 9.1 months.