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. 2024 Jul 25;16(7):e65351.
doi: 10.7759/cureus.65351. eCollection 2024 Jul.

Analysis of the Functional Outcome of Arthroscopic Anterior Cruciate Ligament Reconstruction Using the Central Quadriceps Tendon Graft

Ambareesh Parameshwar  1 , Lanka Bhupati Kumar  1 , Supreeth R Donthi  1 , S Gurucharan  1 , Nishanth J Reddy  1 , Varun Gbs  1 , Vishwanath M S  1 , Amruta Gurudatta  2 , Mohammed Shahid  3
Affiliations

Analysis of the Functional Outcome of Arthroscopic Anterior Cruciate Ligament Reconstruction Using the Central Quadriceps Tendon Graft

Ambareesh Parameshwar et al. Cureus. .

Abstract

Introduction: Anterior cruciate ligament (ACL) injuries are common, particularly among athletes, and often result in knee instability and decreased functionality. Arthroscopic ACL reconstruction is the standard treatment, typically using a patellar tendon bone graft (PTBG) or hamstring tendon graft (HTG). The central quadriceps tendon graft (QTG) has been proposed as a superior alternative due to its structural properties.

Methodology: This study involved patients undergoing ACL reconstruction using the central quadriceps tendon graft. Functional outcomes were assessed using the Tegner Lysholm knee score were assessed at preoperative and postoperative intervals of two weeks, three months, and six months. Statistical analysis compared these scores over time.

Results: Among the subjects, 90.6% were male and 9.4% were female. Injuries primarily resulted from sports activities and road traffic accidents (46.9% each). Right-side injuries were more prevalent (65.6%). The mean time from injury to surgery was 9.37 months. The mean graft size was 8.75 mm, and the mean tourniquet time was 105.94 minutes. Preoperative tests showed positive results for anterior drawer, Lachman, and pivot shift tests in most patients, which were negative postoperatively. Significant improvements in knee flexion and Lysholm knee scores were observed. Preoperative knee flexion ranged from 0-100° to 0-120°, improving to 0-120° to 0-130° six months postoperatively. The mean Lysholm knee score improved from 47.06 preoperatively to 93.16 at six months. Excellent outcomes were seen in 78.1% of the patients, with 21.9% achieving good outcomes.

Conclusion: The central quadriceps tendon graft is an effective option for ACL reconstruction, offering excellent functional outcomes and low complication rates. It shows promise as a better alternative to traditional graft types, although further research is necessary to confirm these findings.

Keywords: acl reconstruction; anterior cruciate ligament; arthroscopy; knee stability; quadriceps tendon graft; sports injuries; tegner lysholm knee score.

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Conflict of interest statement

Human subjects: Consent was obtained or waived by all participants in this study. Institutional Ethics Review Board (IERB) of Vydehi Institute of Medical Sciences and Research Centre, Bangalore issued approval VIEC/PG/APP/031/2020-21. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. Case 1: six-month follow-up knee flexion
Figure 2
Figure 2. Case 1: six-month follow-up knee extension
Figure 3
Figure 3. Case 2: six-month follow-up knee flexion
Figure 4
Figure 4. Case 2: six-month follow-up knee extension
See this image and copyright information in PMC

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