All inside full thickness quadriceps tendon ACL reconstruction: Long term follow up results

Abstract

The aim of this study is to evaluate results of anterior cruciate ligament reconstruction (ACL) using an All-Inside Full Thickness Quadriceps Reconstruction technique at 5 years follow up. Methods: This is a Retrospective cohort study of patients undergoing ACL reconstruction. Inclusion criteria for this report were isolated primary ACL reconstructions without chondral lesions (Grade III/IV Outerbridge), using autologous full-thickness quadriceps tendon (FQT) graft with bone block, with an "all-inside" technique. Functional scales of Lysholm, IKDC, Tegner and objective results of side to side difference (KT1000) were used for this evaluation. Additionally, complications and comorbidities were also analyzed. Results: Two hundred and ninety-one ACL reconstructions were retrospectively reviewed at 5 years postoperatively; 268 (92.1%) were men and 23 (7.90%) women. Lysholm Score improved from 64 (SD = 6.09) to 91 (SD = 6.05) points average. IKDC showed 59.79%, excellent and 3.4% good results. Arthrometric analysis showed that 259 knees (89%) had a difference of less than 3 mm. Median pre-injury Tegner score was 9 (Range 4-10), while final median Tegner activity level at 5 years was 8 (Range 4-10). Among comorbidities, 5.15% of the patients presented anterior knee pain. No visualization difficulties or significant hematomas were found. Conclusion: Use of all inside FQT for ACL reconstruction in a young, high demand sports population, present at 5 years, good to excellent results, functionally and objectively, with low rates of complications and comorbidities.

Failure rates of common grafts used in ACL reconstructions: a systematic review of studies published in the last decade

“…Due to the fact that frequent use of QTA in ACL reconstruction surgery was pushed in the past few years, there is a lack of long-term follow-up studies investigating this graft option. The scientific debate about ACL reconstruction surgery could benefit from high-quality studies investigating long-term (10 years and more) failure rates and functional outcomes of the QTA [15,16]. Furthermore, a lot of quality research has been done on the comparison of graft failure rates of HTA with BPTBA in the last decade [17].…”

Anterior Cruciate Ligament (ACL) Reconstruction Augmented With Bone Marrow Concentrate, Demineralized Bone Matrix, Autograft Bone, and a Suture Tape (The Fertilized ACL)

“…Our IKDC of 81 of 87 or 93% compares favorably with those previously reported in the literature with similar quad tendon ACL reports. Galan et al 8 showed 59% of patient to have normal IKDC scores; however, that study had a larger population and followed patients for 5 years. We feel this is the first step to show the fertilized ACL can be a great addition to the all inside ACL technique in the future.…”

“…Galan et al. 8 showed 59% of patient to have normal IKDC scores; however, that study had a larger population and followed patients for 5 years. We feel this is the first step to show the fertilized ACL can be a great addition to the all inside ACL technique in the future.…”

Minimally Invasive Quad Harvest Featuring Endoscopic Closure and Preparation With Adjustable Suspensory Fixation Device Incorporated With Braided Suture

“… 4 Recently, long-term follow-up for quad tendon all-inside ACL reconstruction has shown good-to-excellent results. 5 The all-inside technique also has been shown to have equivalent stability testing at 2 years' follow-up to BTB standard reconstructions. 6 The quadriceps tendon graft has advantages, including its cross-sectional area, and has been shown to have as low as a 4.2% failure rate.…”