134.
Patellatendon v. quadricepstendon for anterior cruciate ligament
reconstruction - a prospective and randomized study.
Bent Lund, Svend Erik Christiansen, Torsten Nielsen, Peter Faunø, Martin
Lind
Div of Sportstrauma, Orthopedic Dept. Aarhus University Hospital; Div of
Sportstrauma, Orthopedic Dept. , Aarhus University Hospital; Div of
Sportstrauma, Orthopedic Dept. , Aarhus University Hospital; Div of
Sportstrauma, Orthopedic Dept. , Aarhus University Hospital; Div of
Sportstrauma, Orthopedic Dept. , Aarhus University Hospital
Background:
Anterior Cruciate Ligament reconstruction (ACLR) with Bone-
Patella-Bone (BPB) had previosly been shown to be associated with post-
operative anterior knee pain. ACLR with Quadriceps-Tendon-Bone (QTB)
could potentially reduce the anterior knee pain due to reduced bone harvest.
Purpose / Aim of Study:
The purpose of this study was to compare outcome
of ACLR using BTB or QTB graft in a prospective randomized study. We
hypothesized more anterior knee pain for patients reconstructed with BTB
grafts compared to QTB grafts.
Materials and Methods:
From 2005 to 2009, a total of 60 patients were
included in the present study. Inclusion criteria were isolated ACL injuries in
adults. 51 patients were available for follow-up. Of the patients available for
follow-up 25 patients were randomized to BPTB grafts and 26 to QTB grafts.
Follow-up evaluations were performed by an independent examiner at 1 and 2
years postoperatively. Antero- posterior knee laxity measured with a KT-1000
arthrometer. Patient evaluated outcome was performed by KOOS, and
subjective IKDC score. Anterior knee pain was assessed with Knee walking
ability test in which a 2 meters of knee walk is graded by the patients
Findings / Results:
The knee walking ability test demonstrated significantly
less anterior knee pain in the QTB group, with only 7% of patients grading
knee walking difficult or impossible compared to 34 % in the BPTB group. At
one and two years follow-up there was no difference the two groups in patient
evaluated outcome. Anterior knee laxity was equal between the two groups.
Conclusions:
The use of the Quadriceps Tendon Bone graft results in less
anterior pain than BTB grafts but has similar subjective and knee stability
outcome. The QTB graft could be a better graft alternative for ACLR than
BTB grafts in patients not suitable for hamstring grafts and with kneeling
activities.
