Comparison of functional outcome between bone quadriceps tendon (BQT) and single-bundle hamstring tendon (SBHT) autograft in arthroscopic-assisted anterior cruciate ligament reconstruction cases: a prospective cohort study

Andri Mt Lubis, Demy Faheem Dasril, Andri Mt Lubis, Demy Faheem Dasril

Abstract

Background: ACL rupture has a high morbidity in productive-age population. The increasing incidence and proper management has become a point of interest in the musculoskeletal sport injury. Choosing the best graft has become the main focus in searching for a better outcome regarding ACL reconstruction in these patient population. Currently, single bundle hamstring tendon (SBHT) autograft was preferred in Asian population compared to bone quadriceps tendon (BQT) autograft. However, there are some problems such as short and small in diameter of SBHT. This study is focused on evaluation of the clinical outcome between BQT and SBHT in arthroscopic-assisted ACL reconstruction patients.

Materials and methods: In this prospective cohort study, 30 subjects were divided into 2 groups (BQT and SBHT). Sampling was taken between February 2017-2018 (1 year) in one orthopaedic center. The instruments used for evaluation are rolimeter and patient-reported outcome (PRO) questionnaires (IKDC, Tegner-Lysholm, and KOOS) with data mining between 3 months, 6 months, and 1 year post operation. This study has been reported in line with the STROCSS criteria.

Results: Mean difference of quadriceps (3.12 ± 0.94) and hamstring (3.87 ± 0.61) in rolimeter measurement 1 year post operation is statistically significant (p = 0.015). Side-to-side difference shows better result in quadriceps (0.34 ± 0.70) compared to hamstring (0.84 ± 0.60) with p value 0.04. IKDC scores in one month (p = 0.002; CI95% [8.81-31.79]) and three months (p = 0.004; CI95% [4.85-20.39]) post operative is better in quadriceps group. Tegner-Lysholm assessment 1 month post operative showed consistent results between numeric (p = 0.004) and categoric data (p = 0.050) in quadriceps group. There was an improvement during six months and one year post operative KOOS sub-item scales; pain (p = 0.034) and symptoms (p = 0.001).

Conclusion: Functional outcome of patient undergoing arthroscopic-assisted ACL reconstruction is better in BQT group compared to SBHT group, both in subjective and objective parameters given.

Keywords: ACL reconstruction; Arthroscopic-assisted; BQT and SBHT graft.

Conflict of interest statement

There are no such conflicts of interest in this study

© 2020 The Authors. Published by Elsevier Ltd on behalf of IJS Publishing Group Ltd.

Figures

Fig. 1
Fig. 1
Research Protocol using Patient-Reported Outcome (PRO) and Rolimeter Examinations to Assess Functional Outcome.
Fig. 2
Fig. 2
BQT autograft model used in this study; bone plug is utilized in the femoral tunnel to enhance graft incorporation and healing.
Fig. 3
Fig. 3
SBHT autograft model used in this study; graft incorporation and healing depends on soft tissue properties of the graft.
Fig. 4
Fig. 4
Graphic of IKDC scoring comparison between groups in pre-operative and post-operative follow up.
Fig. 5
Fig. 5
Graphic of Tegner-Lysholm scoring comparison between groups in pre-operative and post-operative follow up.
Fig. 6
Fig. 6
Graphic of KOOS scoring comparison between groups in pre-operative and post-operative follow up.

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