Clinical comparison of the autologous quadriceps tendon (BQT) and the autologous patella tendon (BPTB) for the reconstruction of the anterior cruciate ligament.
The use of the BPTB-autograft is a very common method for ACL reconstruction. Nevertheless, the problem of the typical donor-site-morbidity is unresolved. Recently, a transplant of quadriceps tendon, with an attached bone block (BQT) has been increasingly relied upon. The purpose of this study was to examine the clinical results of a group of patients after arthroscopic ACL reconstruction using either BPTB or quadriceps tendon autograft after a minimum follow-up of 2 years in terms of knee joint stability and function using both subjective and objective criteria. Retrospective study. A total of 260 patients with ACL ruptures were operated between 1995 and 2000; 124 received a BQT-autograft, including 8 revisions; 136 patients received a BPTB-autograft, exclusively primary interventions. The results were evaluated using the IKDC-, Noyes- and Lysholm-Scores. It was possible to re-evaluate 194 patients after a minimum follow-up period of 2 years, 64 of 260 patients (25%) were lost to follow-up. Ninety-seven percent of the operated knee joints in the BPTB-group were judged as normal or almost normal with the IKDC evaluation, as were 83% in the BQT-group (P < or = 0.001). The BQT-group showed a significantly better result in the evaluation of the donor-site-morbidity. We found no significant differences in the functional outcome according to the Lysholm- and Noyes-Score. In comparison to the results after using a BQT-transplant for reconstruction of a ruptured ACL the use of the BPTB-transplant is in favour concerning patient satisfaction and IKDC evaluation. For patients with activities involving kneeling or prolonged flexion of the knee joint BQT-transplants can be a good alternative, however.
Gorschewsky
O
O
Department of Sportorthopaedics, Klinik Sonnenhof, Buchserstrasse 30, 3006 Bern, Switzerland. ottmar.gorschewsky@sonnenhof.ch
Klakow
A
A
Pütz
A
A
Mahn
H
H
Neumann
W
W
D000328:Adult; D000070598:Anterior Cruciate Ligament Injuries; D001182:Arthroscopy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007718:Knee Injuries / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D017847:Patellar Ligament / Q000637:transplantation*; D017060:Patient Satisfaction; D052097:Quadriceps Muscle; D016059:Range of Motion, Articular; D012189:Retrospective Studies; D016896:Treatment Outcome