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Knee Surgery, Sports Traumatology, Arthroscopy

Erschienen in:

04.02.2020 | KNEE

Lower donor-site morbidity using QT autografts for ACL reconstruction

verfasst von: Dany Mouarbes, Louis Dagneaux, Matthieu Olivier, Vincent Lavoue, Enrique Peque, Emilie Berard, Etienne Cavaignac

Erschienen in: Knee Surgery, Sports Traumatology, Arthroscopy | Ausgabe 8/2020

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Abstract

Purpose

Comparing scar cosmesis and regional hypoesthesia at the incision site between quadriceps tendon (QT), bone–patellar tendon–bone (BPTB), and hamstring tendon (HT) for anterior cruciate ligament (ACL) reconstruction.

Methods

Ninety patients undergoing ACL reconstruction with QT, HT or BPTB were evaluated at 1-year post-op. Scar cosmesis was assessed using the patient and observer scar assessment scale (POSAS) and length of the incision. Sensory outcome was analyzed by calculating the area of hypoesthesia around the scar. The classical ACL reconstruction functional follow-up was measured using the Lysholm score and KOOS.

Results

Concerning QT versus BPTB group, QT patients have a significantly lower mean POSAS (24.8 ± 6.3 vs. 39.6 ± 5.8; p < 0.0001), shorter mean incision (2.8 ± 0.4 cm vs. 6.4 ± 1.3 cm; p < 0.0001), lower extent of hypoesthesia (8.7 ± 5.1 cm² vs. 88.2 ± 57 cm²; p < 0.0001), and better Lysholm score (90.1 ± 10.1 vs. 82.6 ± 13.5; n.s.). No significant difference was seen in KOOS (90.7 ± 7.2 vs. 88.4 ± 7.0; n.s.). Concerning QT versus HT group, no significant difference was found regarding mean POSAS score (24.8 ± 6.3 vs. 31.8 ± 6.2; n.s.), mean length of the incision (2.8 ± 0.4 cm vs. 2.5 ± 0.6 cm; n.s.), KOOS (90.7 ± 7.2 vs. 89.8 ± 8.2; n.s.) and mean Lysholm score (90.1 ± 10.1 vs. 87.8 ± 0.6; n.s.). The mean measured area of hypoesthesia was significantly higher in the HT group (70.3 ± 77.1 cm² vs. 8.7 ± 5.1 cm²; p < 0.0001).

Conclusion

Quadriceps tendon harvesting technique has the safest incision by causing less sensory loss compared to BPTB and HT. It also has the advantage of a short incision with more cosmetic scar compared to BPTB, with no difference compared to HT. However, no significant difference in terms of functional outcome was shown between the three autografts. These findings provide surgeons evidence about their clinical practice and help with graft choice decisions.

Level of evidence

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Titel: Lower donor-site morbidity using QT autografts for ACL reconstruction
verfasst von: Dany Mouarbes
Louis Dagneaux
Matthieu Olivier
Vincent Lavoue
Enrique Peque
Emilie Berard
Etienne Cavaignac
Publikationsdatum: 04.02.2020
Verlag: Springer Berlin Heidelberg
Erschienen in: Knee Surgery, Sports Traumatology, Arthroscopy / Ausgabe 8/2020
Print ISSN: 0942-2056
Elektronische ISSN: 1433-7347
DOI: https://doi.org/10.1007/s00167-020-05873-1

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Lower donor-site morbidity using QT autografts for ACL reconstruction