Low surgical routine increases revision rates after quadriceps tendon autograft for anterior cruciate ligament reconstruction: results from the Danish Knee Ligament Reconstruction Registry.

Szczegóły
Abstrakt

Tytuł:: Low surgical routine increases revision rates after quadriceps tendon autograft for anterior cruciate ligament reconstruction: results from the Danish Knee Ligament Reconstruction Registry.
Autorzy:: Lind M; Aarhus University Hospital, Department of Orthopaedics, Palle Juul-Jensens Boulevard 99, Aarhus N, 8200, Aarhus, Denmark. .
Strauss MJ; Orthopedic Clinic, Oslo University Hospital and Oslo Sports Trauma Research Center, Norwegian School of Sport Sciences, Oslo, Norway.
Nielsen T; Aarhus University Hospital, Department of Orthopaedics, Palle Juul-Jensens Boulevard 99, Aarhus N, 8200, Aarhus, Denmark.
Engebretsen L; Orthopedic Clinic, Oslo University Hospital and Oslo Sports Trauma Research Center, Norwegian School of Sport Sciences, Oslo, Norway.
Źródło:: Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA [Knee Surg Sports Traumatol Arthrosc] 2021 Jun; Vol. 29 (6), pp. 1880-1886. Date of Electronic Publication: 2020 Sep 04.
Typ publikacji:: Journal Article
Język:: English
Imprint Name(s):: Original Publication: [Heidelberg, Germany] : Springer International, c1993-
MeSH Terms:: Anterior Cruciate Ligament Injuries/*surgery
Anterior Cruciate Ligament Reconstruction/*methods
Quadriceps Muscle/*transplantation
Tendons/*transplantation
Adolescent ; Adult ; Aged ; Anterior Cruciate Ligament Reconstruction/adverse effects ; Anterior Cruciate Ligament Reconstruction/statistics & numerical data ; Denmark ; Female ; Hamstring Tendons/transplantation ; Humans ; Joint Instability/etiology ; Knee Joint/surgery ; Male ; Middle Aged ; Patellar Ligament/transplantation ; Postoperative Complications ; Registries ; Reoperation ; Transplantation, Autologous ; Young Adult
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Contributed Indexing:: Keywords: ACL reconstruction; Clinical outcomes; Hamstring tendon; Patellar tendon; Quadriceps tendon
Entry Date(s):: Date Created: 20200905 Date Completed: 20210609 Latest Revision: 20210609
Update Code:: 20240104
DOI:: 10.1007/s00167-020-06220-0
PMID:: 32886156
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Purpose: Recent registry data have demonstrated a higher revision rate of quadriceps tendon (QT) graft compared with hamstring tendon (HT) and patellar tendon (PT) grafts. Clinic routines could be an important factor for revision outcomes. The purpose of this study is to use the Danish Knee Ligament Reconstruction Registry (DKRR) to compare revision rates in patients who have undergone ACLR with QT, HT and PT grafts related to individual clinic surgical routine.
Methods: Data on primary ACLRs entered in the DKRR from 2012 through 2019 were analysed since QT graft usage started in 2012. Revision rates for QT, HT and PT grafts were compared according to clinic activity (0-100 and > 100 procedures). Revision rates for the three autograft cohorts are presented, as well as adjusted revision hazard rates. Instrumented knee stability and pivot-shift tests were performed at a one-year follow-up.
Result: QT revision rate (6.4%) for low-activity clinics was higher than for high-activity clinics (2.9%) (p = 0.003). The adjusted revision hazard ratio for low-activity clinics was 2.3 (p = 0.01). QT autograft was associated with statistically significant, increased side-to-side laxity at follow-up (1.4 mm) compared with HT and PT autografts (1.0 mm) (p < 0.01), as well as an increased positive pivot-shift rate.
Conclusion: QT autografts for ACLR were associated with higher revision rates in clinics with lower than 100 procedures performed from 2012 to 2019. QT graft usage is not associated with a high revision rate when routinely performed. Learning curve is an important factor when introducing QT ACLR.
Level of Evidence: Level III.

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