Anterior cruciate ligament reconstruction: autogenous quadriceps tendon-bone compared with bone-patellar tendon-bone grafts at 2-year follow-up.
OBJECTIVE
The purpose of this study was to evaluate and compare postoperative anterior knee pain, knee stability, and functional scores of an autogenous bone-patellar tendon-bone (BPTB) graft and a quadriceps tendon-bone (QTB) graft.


METHODS
A total of 48 patients--27 who had anterior cruciate ligament (ACL) reconstruction by use of an autogenous BPTB graft and 21 who had ACL reconstruction by use of a QTB graft--were assessed at a minimum follow-up of 24 months after surgery. An accelerated rehabilitation program was adapted, and the rehabilitation protocol was identical for both groups.


RESULTS
The mean side-to-side difference as measured with a KT-2000 arthrometer (MEDmetric, San Diego, CA) was 2.73 mm (SD, 1.45 mm) in the BPTB group and 2.79 mm (SD, 1.32 mm) in the QTB group (P = .880). Postoperatively, the International Knee Documentation Committee score was grade A or B in 23 patients (85.2%) in the BPTB group and 18 (85.7%) in the QTB group (P = .997). The mean anterior knee pain score was 86.9 in the BPTB group as compared with 90.2 in the QTB group (P = .107). In a kneeling posture, 13 BPTB patients reported discomfort (moderate in 10 and severe in 3) whereas only 4 QTB patients had moderate discomfort (P = .029). No significant differences were found with regard to other activities surveyed.


CONCLUSIONS
A QTB graft attached with the EndoPearl device (Linvatec, Largo, FL) appears to be an effective alternative for single-bundle ACL reconstruction. When followed with an accelerated rehabilitation program, reconstruction with a QTB graft provided knee stability comparable to a BPTB graft but with less kneeling pain than a BPTB graft.
Kim
Sung-Jae
SJ
Department of Orthopaedic Surgery, Yonsei University Health System, Yonsei University Arthroscopy & Joint Research Institute, Seoul, South Korea.
Kumar
Praveen
P
Oh
Kyung-Soo
KS
D000293:Adolescent; D000328:Adult; D016118:Anterior Cruciate Ligament / Q000601:surgery*; D001182:Arthroscopy / Q000379:methods*; D016025:Bone Transplantation / Q000379:methods*; D001915:Braces; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007593:Joint Instability / Q000453:epidemiology; D008297:Male; D008592:Menisci, Tibial / Q000601:surgery; D008875:Middle Aged; D009984:Orthopedic Fixation Devices; D010146:Pain / Q000453:epidemiology; D017847:Patellar Ligament / Q000637:transplantation*; D011183:Postoperative Complications / Q000453:epidemiology; D011187:Posture; D019651:Plastic Surgery Procedures / Q000379:methods* / Q000534:rehabilitation; D020127:Recovery of Function; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013710:Tendons / Q000637:transplantation*; D000070600:Tibial Meniscus Injuries; D055815:Young Adult