Most Patients Report Acceptable Knee Function, Satisfaction, and Clinical Outcomes at a Minimum Ten Years After Quadriceps Free Tendon Anterior Cruciate Ligament Reconstruction.

PURPOSE

To describe the long-term outcomes of anterior cruciate ligament reconstruction (ACLR) with quadriceps-free tendon autograft (QFT) in terms of subjective function, clinical outcomes, and knee satisfaction.

METHODS

A retrospective chart review design with prospective descriptive survey was used to determine clinical and subjective outcomes for patients treated with a QFT-ACLR from 2000 to 2013. Patients with multiligament reconstructions were excluded. The primary outcomes were clinical outcomes (reinjury of indexed knee, ACL injury to contralateral knee after indexed surgery), subjective function (International Knee Documentation Committee subjective score, Lysholm score), knee satisfaction (single assessment numeric evaluation), and global health and wellbeing (Patient-Reported Outcomes Measurement Information System Global-10).

RESULTS

In total, 34 patients were contacted (average: 18.2 years, range: 10-23 years) after surgery (response rate, 17.3%). The mean age at time of surgery was 32.3 ± 11.1 years, and 50.4 ± 11.6 years at follow-up. For clinical outcomes, 23.5% of patients reported a reinjury of their QFT reconstructed ACL. Contralateral ACL injuries were reported in 17.6% of patients. No differences in subjective function and knee satisfaction were identified between patients with and without concomitant procedure at the time of surgery. Nearly two-thirds of patients reported strong mental health and physical function on the PROMIS Global Health.

CONCLUSIONS

This study presents a minimum of 10-year follow-up on QFT-ACLR, revealing 74% of patients reporting no reinjury, 67% of patients reporting acceptable-exceptional subjective knee function, and 74% indicating better physical and mental health compared to the general population. No differences were observed in knee function or satisfaction scores among patients who underwent a concomitant cartilage procedure at the time of QFT-ALCR with patients without these concomitant injuries.

LEVEL OF EVIDENCE

Level IV, therapeutic case-series.