Arthroscopic anterior cruciate ligament reconstruction with quadriceps tendon autograft

Clinical outcome in 4-7 years

Chih Hwa Chen, Tai Yuan Chuang, Kun Chuang Wang, Wen Jer Chen, Chun Hsiung Shih

Research output: Contribution to journalArticle

52 Citations (Scopus)

Abstract

Surgical reconstruction of the anterior cruciate ligament (ACL) is indicated in the ACL-deficient knee with symptomatic instability and multiple ligaments injuries. In the present study, we describe the clinical results of quadriceps tendon-patellar bone autograft for ACL reconstruction. From 1996 to 1998, the graft has been used in 38 patients. Thirty-four patients with complete final follow-up for 4-7 years were analyzed. The average follow-up time was 62 (48-84) months. Thirty-two patients (94%) achieved good or excellent results by Lysholm knee rating. Twenty-six patients (76%) could return to moderate or strenuous activity after reconstruction. Twenty-eight patients (82%) had ligament laxity of less than 2 mm. Finally; 31 patients (91%) were assessed as normal or nearly normal rating by IKDC guideline. Twenty-five patients (73%) had less than 10 mm difference in thigh girth between their reconstructed and normal limbs. Thirty-two (94%) and 31 (91%) patients could achieve recovery of the extensor and flexor muscle strength in the reconstructed knee to 80% or more of normal knee strength, respectively. A statistically significant difference exists in thigh girth difference, extensor strength ratio, and flexor strength ratio before and after reconstruction. Tunnel expansion with more than 1 mm was identified in 2 (6%) tibial tunnels. Our study revealed satisfactory clinical subjective and objective results at 4-7 years follow-up. Quadriceps tendon autograft has the advantage of being self-available, relatively easier arthroscopic technique, and having a suitable size, making it an acceptable graft choice for ACL reconstruction. There is little quadriceps muscle strength loss after quadriceps harvest. A quadriceps tendon-patellar autograft is an adequate graft choice to ACL reconstruction.

Original languageEnglish
Pages (from-to)1077-1085
Number of pages9
JournalKnee Surgery, Sports Traumatology, Arthroscopy
Volume14
Issue number11
DOIs
Publication statusPublished - Nov 2006
Externally publishedYes

Fingerprint

Anterior Cruciate Ligament Reconstruction
Autografts
Tendons
Knee
Patellar Ligament
Muscle Strength
Thigh
Transplants
Ligaments
Multiple Trauma
Anterior Cruciate Ligament
Quadriceps Muscle
Extremities
Guidelines
Bone and Bones

Keywords

  • Anterior cruciate ligament
  • Arthroscopy
  • Clinical outcome
  • Quadriceps tendon graft
  • Reconstruction

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine
  • Physical Therapy, Sports Therapy and Rehabilitation
  • Surgery

Cite this

Arthroscopic anterior cruciate ligament reconstruction with quadriceps tendon autograft : Clinical outcome in 4-7 years. / Chen, Chih Hwa; Chuang, Tai Yuan; Wang, Kun Chuang; Chen, Wen Jer; Shih, Chun Hsiung.

In: Knee Surgery, Sports Traumatology, Arthroscopy, Vol. 14, No. 11, 11.2006, p. 1077-1085.

Research output: Contribution to journalArticle

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abstract = "Surgical reconstruction of the anterior cruciate ligament (ACL) is indicated in the ACL-deficient knee with symptomatic instability and multiple ligaments injuries. In the present study, we describe the clinical results of quadriceps tendon-patellar bone autograft for ACL reconstruction. From 1996 to 1998, the graft has been used in 38 patients. Thirty-four patients with complete final follow-up for 4-7 years were analyzed. The average follow-up time was 62 (48-84) months. Thirty-two patients (94{\%}) achieved good or excellent results by Lysholm knee rating. Twenty-six patients (76{\%}) could return to moderate or strenuous activity after reconstruction. Twenty-eight patients (82{\%}) had ligament laxity of less than 2 mm. Finally; 31 patients (91{\%}) were assessed as normal or nearly normal rating by IKDC guideline. Twenty-five patients (73{\%}) had less than 10 mm difference in thigh girth between their reconstructed and normal limbs. Thirty-two (94{\%}) and 31 (91{\%}) patients could achieve recovery of the extensor and flexor muscle strength in the reconstructed knee to 80{\%} or more of normal knee strength, respectively. A statistically significant difference exists in thigh girth difference, extensor strength ratio, and flexor strength ratio before and after reconstruction. Tunnel expansion with more than 1 mm was identified in 2 (6{\%}) tibial tunnels. Our study revealed satisfactory clinical subjective and objective results at 4-7 years follow-up. Quadriceps tendon autograft has the advantage of being self-available, relatively easier arthroscopic technique, and having a suitable size, making it an acceptable graft choice for ACL reconstruction. There is little quadriceps muscle strength loss after quadriceps harvest. A quadriceps tendon-patellar autograft is an adequate graft choice to ACL reconstruction.",
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