Quadriceps tendon anterior cruciate ligament reconstruction

Diermeier, Theresa; Tisherman, Rob; Hughes, Jonathan D.; Tulman, Michael; Coffey, Erica Baum; Fink, Christian; Lynch, Andrew D.; Fu, Freddie H.; Musahl, Volker

doi:10.1007/s00167-020-05902-z

Cited by 57 publications

(72 citation statements)

References 75 publications

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“…30 An advantage of the QT graft for anatomic ACL reconstruction is the opportunity to harvest a full-thickness graft as well as a partial-thickness tendon graft with or without an additional bone block. 5 So far, several clinical studies have demonstrated good to excellent clinical outcome scores after anatomic ACL reconstruction using QT graft.…”

Section: Discussionmentioning

confidence: 99%

“…Recently, interest has arisen in the quadriceps tendon (QT) as an alternative autologous graft option for primary ACL reconstruction. 5,31 This graft shows morphologic and biomechanical characteristics that produce a suitable graft for ACL reconstruction. 30,33,35 In a cadaveric study, ACL reconstruction using a QT autograft resulted in similar knee stability compared with using a quadrupled semitendinosus-gracilis tendon autograft.…”

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confidence: 99%

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Comparing Knee Laxity After Anatomic Anterior Cruciate Ligament Reconstruction Using Quadriceps Tendon Versus Semitendinosus Tendon Graft

Karpinski

Häner

Bierke

et al. 2021

Orthopaedic Journal of Sports Medicine

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Background: The choice of graft in anterior cruciate ligament (ACL) reconstruction is still under discussion. The hamstrings are currently the most used grafts for primary ACL reconstruction in Europe. However, increased interest has arisen in the quadriceps tendon (QT) as an alternative autologous graft option for primary ACL reconstruction. Purpose: To evaluate knee stability and the subjective outcome after ACL reconstruction using either autologous QT graft in implant-free femoral press-fit fixation technique or semitendinosus tendon (ST) graft. Study Design: Cohort study; Level of evidence, 2. Methods: We evaluated 50 patients who underwent ACL reconstruction, including 25 patients who received autologous ipsilateral QT graft (QT group) and 25 patients who received the ipsilateral ST graft (ST group). The follow-up for this prospective comparative study was at least 2 years after surgery, comprising KT-1000 arthrometer testing, pivot-shift test, Knee injury and Osteoarthritis Outcome Score (KOOS), Lysholm score, and rerupture rate. Results: The mean patient age was 31.72 years (9 women, 16 men) in the QT group and 32.08 years (13 women, 12 men) in the ST group. The mean ± standard deviation postoperative side-to-side difference assessed using KT-1000 arthrometer was 1.56 ± 1.56 mm for the QT group and 1.64 ± 1.41 mm for the ST group, with no significant difference. No significant difference was found on any of the KOOS subscale scores ( P = .694) or the Lysholm score ( P = .682). No rerupture or positive pivot-shift test occurred during follow-up. No difference was found in donor-site morbidity between the study groups. Conclusion: Clinical outcomes were not significantly different between QT and ST grafts in the current study. Thus, the QT may serve as a good alternative graft for primary ACL reconstruction.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Comparing Knee Laxity After Anatomic Anterior Cruciate Ligament Reconstruction Using Quadriceps Tendon Versus Semitendinosus Tendon Graft

Karpinski

Häner

Bierke

et al. 2021

Orthopaedic Journal of Sports Medicine

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“…As a common athletic injury, ACL rupture can cause serious damage such as knee joint instability, injury to other ligaments, dislocation, and osteoarthritis [2,3]. ACL reconstruction is currently consid-ered the gold standard for treating ACL rupture, and grafts including autografts, allografts, and synthetic grafts are used for this purpose [4][5][6]. However, these grafts have some limitations.…”

Section: Introductionmentioning

confidence: 99%

Bone Mesenchymal Stem Cells Contribute to Ligament Regeneration and Graft–Bone Healing after Anterior Cruciate Ligament Reconstruction with Silk–Collagen Scaffold

Chen

Liu

et al. 2021

Stem Cells International

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Anterior cruciate ligament (ACL) reconstruction was realized using a combination of bone mesenchymal stem cells (BMSCs) and silk–collagen scaffold, and an in vivo evaluation of this combination was performed. By combining type I collagen and degummed silk fibroin mesh, silk–collagen scaffolds were prepared to simulate ligament components. BMSCs isolated from bone marrow of rabbits were cultured for a homogenous population and seeded on the silk–collagen scaffold. In the scaffold and BMSC (S/C) group, scaffolds were seeded with BMSCs for 72 h and then rolled and used to replace the ACL in 20 rabbits. In the scaffold (S) group, scaffolds immersed only in culture medium for 72 h were used for ACL reconstruction. Specimens were collected at 4 and 16 weeks postoperatively to assess ligament regeneration and bone integration. HE and immunohistochemical staining (IHC) were performed to assess ligament regeneration in the knee cavity. To assess bone integration at the graft–bone interface, HE, Russell–Movat staining, micro-CT, and biomechanical tests were performed. After 4 weeks, vigorous cell proliferation was observed in the core part of the scaffold in the S/C group, and a quantity of fibroblast-like cells and extracellular matrix (ECM) was observed in the center part of the graft at 16 weeks after surgery. At 4 and 16 weeks postoperatively, the tenascin-C expression in the S/C group was considerably higher than that in the S group (4 w, p < 0.01 ; 16 w, p < 0.01 ). Furthermore, bone integration was better in the S/C group than in the S group, with histological observation of trabecular bone growth into the graft and more mineralized tissue formation detected by micro-CT (4 w, bone volume fraction (BV/TV), p = 0.0169 , bone mineral density (BMD), p = 0.0001 ; 16 w, BV/TV, p = 0.1233 , BMD, p = 0.0494 ). These results indicate that BMSCs promote ligament regeneration in the knee cavity and bone integration at the graft–bone interface. Silk–collagen scaffolds and BMSCs will likely be combined for clinical practice in the future.

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“… 7 , 12 The use of allograft in comparison to autograft has also been identified as a risk factor for reconstruction failure, especially in younger more active patients. 7 It is important to note that regardless of graft type, anatomic ACLR is considered the benchmark, reconstructive technique, 13 as it has been shown that anatomic ACLRs reduce the risk of posttraumatic osteoarthritis (OA) at long-term follow-up. 14 Given the multitude of graft options and risk factors for failure, it is critical that the operating surgeon have a comprehensive discussion with the patient regarding which graft option(s) would be most suitable for the patient's individualized reconstruction, particularly given that the surgeon's recommendation has been shown to be one of the most important factors behind the patient's graft choice.…”

Section: Graft Choicesmentioning

confidence: 99%

Graft Selection in Contemporary Anterior Cruciate Ligament Reconstruction

2021

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In the last decade, there have been significant advances in our understanding of anterior cruciate ligament (ACL) reconstruction. Recent prospective cohort studies have identified risk factors for ACL reconstruction graft failure such as younger patient age, increased activity level, nonanatomic tunnel placement, and the use of allograft. Among these, the most easily modifiable risk factor is graft choice. Given that the surgeon's recommendation has been shown to be one of the most important factors behind patients' graft choice, it is critical that the operating surgeon have a thorough understanding of all the ACL graft options available to choose the graft that would be most suitable for the patient's personalized reconstruction (i.e., patient's anatomy, sport, level of competition, age, risk factors for failure, and graft used in previous ACL surgery). The purpose of this review is to provide an up-to-date understanding of the current ACL graft reconstruction options. The indications, advantages, and disadvantages of the different ACL reconstruction graft options available will be discussed.

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Quadriceps tendon anterior cruciate ligament reconstruction

Cited by 57 publications

References 75 publications

Comparing Knee Laxity After Anatomic Anterior Cruciate Ligament Reconstruction Using Quadriceps Tendon Versus Semitendinosus Tendon Graft

Comparing Knee Laxity After Anatomic Anterior Cruciate Ligament Reconstruction Using Quadriceps Tendon Versus Semitendinosus Tendon Graft

Bone Mesenchymal Stem Cells Contribute to Ligament Regeneration and Graft–Bone Healing after Anterior Cruciate Ligament Reconstruction with Silk–Collagen Scaffold

Graft Selection in Contemporary Anterior Cruciate Ligament Reconstruction

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