Martin Lind1, Marc J Strauss2, Torsten Nielsen3, Lars Engebretsen2. 1. Aarhus University Hospital, Department of Orthopaedics, Palle Juul-Jensens Boulevard 99, Aarhus N, 8200, Aarhus, Denmark. martinlind@dadlnet.dk. 2. Orthopedic Clinic, Oslo University Hospital and Oslo Sports Trauma Research Center, Norwegian School of Sport Sciences, Oslo, Norway. 3. Aarhus University Hospital, Department of Orthopaedics, Palle Juul-Jensens Boulevard 99, Aarhus N, 8200, Aarhus, Denmark.
Abstract
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.
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.
Authors: Harasees Singh; Isaac Glassman; Andrew Sheean; Yuichi Hoshino; Kanto Nagai; Darren de Sa Journal: Knee Surg Sports Traumatol Arthrosc Date: 2022-10-18 Impact factor: 4.114
Authors: Marc Strauss; Mitchell L Kennedy; Alex Brady; Gilbert Moatshe; Jorge Chahla; Robert F LaPrade; Martin Lind; Lars Engebretsen Journal: Orthop J Sports Med Date: 2021-09-14