title: Anterior cruciate ligament reconstruction using quadriceps tendon autograft: intermediate-term outcome.
abstract: OBJECTIVE
  The purpose of this study was to compare the intermediate-term outcomes of anterior cruciate ligament (ACL) reconstruction by use of bone-patellar tendon-bone (BPTB), quadriceps tendon with a bone plug (BQT), and quadriceps tendon without a bone plug (QT).
  
  
  METHODS
  We evaluated 198 primary ACL reconstructions in 191 patients at a mean of 55.6 months postoperatively. Assessment included side-to-side comparison of range of motion, arthrometer values, presence of effusion, anterior knee pain, and numbness. Comparisons were made between QT and BQT patients and between men and women. The results were compared with data from 30 patients in a previous study who had undergone ACL reconstruction by the same surgeon (W.R.S.) with BPTB.
  
  
  RESULTS
  Range of motion averaged -3.2 degrees +/- 2.2 degrees of extension to 134.3 degrees +/- 10.2 degrees of flexion for the operative extremity compared with -3.6 degrees +/- 2.07 degrees to 134.2 degrees +/- 10.6 degrees for the contralateral extremity at final follow-up. KT-1000 manual maximum measurements (MEDmetric, San Diego, CA) of the operative extremity averaged 0.94 mm more than those of the normal contralateral knee. When compared with BPTB autograft, the quadriceps tendon autograft showed significantly better results, with less anterior knee pain (4.56% v 26.7%), less anterior numbness (1.5% v 53.3%), a higher percentage of arthrometer measurements showing a side-to-side difference of 0 to 3 mm (88% v 68%), and better extension (mean loss, 0.55 degrees v 2.77 degrees ). There was no significant difference between the 2 groups with regard to loss of flexion, Lachman test, pivot-shift test, presence of effusion, or number of failures.
  
  
  CONCLUSIONS
  Central quadriceps tendon autograft, QT or BQT, produces equivalent results when compared directly with BPTB autograft in arthroscopically assisted ACL reconstruction. There was no difference in results between men and women with a quadriceps tendon autograft, either with or without the use of a bone plug. ACL reconstruction using quadriceps tendon autograft is an effective surgical option that reduces donor-site morbidity.
  
  
  METHODS
  Level IV, therapeutic case series.
authors: Mississippi Sports Medicine and Orthopaedic Center, Jackson, Mississippi, USA.
authors: Timothy M
authors: TM
authors: Geib
authors: Walter R
authors: WR
authors: Shelton
authors: Raymond A
authors: RA
authors: Phelps
authors: Lauren
authors: L
authors: Clark
mesh_terms: D000328:Adult; D016118:Anterior Cruciate Ligament / Q000601:surgery*; 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*; D016059:Range of Motion, Articular / Q000502:physiology; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D013997:Time Factors; D014182:Transplantation, Autologous; D016896:Treatment Outcome; D014741:Video Recording