No Difference in Complication Rates or Patient-Reported Outcomes Between Bone-Patella Tendon-Bone and Quadriceps Tendon Autograft for Anterior Cruciate Ligament Reconstruction.

PURPOSE

To compare subjective outcomes and complications of anterior cruciate ligament reconstruction (ACLR) using either bone-patellar tendon-bone (BPTB) or quadriceps tendon (QT) autograft.

METHODS

A retrospective analysis of prospectively collected data identified consecutive cohorts of patients undergoing ACLR with either BPTB or QT autograft. Patients with less than 12-month follow-up and those undergoing concomitant osteotomies, cartilage restoration, and/or other ligament reconstruction procedures were excluded. Pre- and postsurgical patient-reported outcomes including International Knee Documentation Committee, Knee Injury and Osteoarthritis Outcome Score, Patient-Reported Outcomes Measurement Information System (PROMIS), Single Assessment Numeric Evaluation, Tegner, and Marx were compared between groups. Complications requiring reoperation were recorded.

RESULTS

One hundred nineteen patients met inclusion criteria, including 39 QT autografts and 80 BPTB autografts. Demographic information was comparable between groups. Mean follow-up was comparable between groups (QT 22.4 ± 10.6 months vs BPTB 28.5 ± 18.5 months,  = .06). At minimum 12-month follow-up (range 12.0-100.8 months), patients in both groups demonstrated statistically significant improvements in International Knee Documentation Committee (QT 60.0%, < .0001; BPTB 57.7%, < .0001), all Knee Injury and Osteoarthritis Outcome Score domains, PROMIS Mobility T-Score (QT 27.2%,  = .0001; BPTB 23.2%, < .0001), PROMIS Global Physical Health (QT 14.4%,  = .002; BPTB 13.4%,  = .001), PROMIS Physical Function (QT 29.6%, < .0001; BPTB 37.1%, < .0001), PROMIS Pain Interference (QT -16.5%, .0001; BPTB -20.8%, < .0001), Single Assessment Numeric Evaluation, (QT 76.9%,  < .0001; BPTB 73.3%, < .0001), Tegner (QT 92.9%,  = .0002; BPTB 101.4%, < .0001), and Marx (QT -26.6%,  = .02; BPTB -32.0%,  = .0002) with no statistically significant differences between the 2 groups. Overall postoperative reoperation rate did not differ between groups (QT 12.8% vs BPTB 23.8%,  = .2). Revision ACL reconstruction rate did not differ between groups (QT 5.1% vs BPTB 7.5%,  = .6).

CONCLUSIONS

Patients undergoing autograft ACLR with either BPTB or QT demonstrated significant subjective improvements in patient-reported outcomes from preoperative values and no statistically significant differences in outcomes between the groups. Complication and revision ACLR rates were similar between the 2 groups.

LEVEL OF EVIDENCE

III, retrospective cohort study.